ArticleTurkish journal of emergency medicine
Identifying high-risk undifferentiated emergency department patients with hyperlactatemia: Predictors of 30-day in-hospital mortality.
Article in Turkish journal of emergency medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Admission shock indices and lactate for mortality risk stratification in non-traumatic hypotensive patients.Irish journal of medical science · 2026Article
- Nonlinear correlation between lactate levels and 28-day all-cause mortality in patients with sepsis complicated by acute respiratory distress syndrome (ARDS): a retrospective study based on the MIMIC-IV database.BMC medical informatics and decision making · 2026Article
- Predictors of invasive mechanical ventilation requirement and mortality in hypercapnic respiratory failure: A retrospective analysis.Turkish journal of emergency medicineArticle
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5 authors.
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Abstract
backgroundHyperlactatemia has been recognized as a significant prognostic indicator in critically ill patients. Nonetheless, there remains a gap in understanding the specific risk factors contributing to increased mortality among undifferentiated emergency department (ED) patients presenting with elevated lactate levels.
objectivesThe objective of the study is to investigate potential risk factors for 30-day in-hospital mortality in ED patients with hyperlactatemia.
methodsAll nontraumatic adult presentations to the ED who had a lactate level of ≥2.5 mmol/L were included. Comorbidities, vital signs, lactate levels, lactate clearance, lactate normalization, and final diagnosis were compared with 30-day in-hospital mortality.
resultsA 30-day in-hospital mortality rate of 10.4% was observed in 979 patients. The mortality rate was higher in hypotensive patients (odds ratio [OR] 4.973), in nursing home patients (OR 5.689), and bedridden patients (OR 3.879). The area under the curve for the second lactate level (0.804) was higher than the first lactate level (0.691), and lactate clearance (0.747) for in-hospital mortality. A second lactate level >3.15 mmol/l had a sensitivity of 81.3% in predicting in-hospital mortality. The OR for mortality was 6.679 in patients without lactate normalization. A higher mortality rate was observed in patients with acute renal failure (OR 4.305), septic shock (OR 4.110), and acute coronary syndrome (OR 2.303).
conclusionsA second lactate measurement more accurately predicts in-hospital mortality than lactate clearance and the first lactate level in ED patients. Nursing home patients, bed-ridden patients, hypotensive patients on initial ED presentation, patients without lactate normalization, and patients with a final diagnosis of acute renal failure, septic shock, and acute coronary syndrome had a higher mortality rate.
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