ArticleBMC emergency medicine2024
Severe hyperlactatemia in the emergency department: clinical characteristics, etiology and mortality.
Article in BMC emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- 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
- Walking ability as a prognostic indicator in elderly patients with community-acquired pneumonia: a retrospective multicenter study.BMC geriatrics · 2026Observational
- Impact of Renal Replacement Therapy on Severe Lactic Acidosis in Intensive Care Unit Patients: A MIMIC-IV Retrospective Replication Analysis.Kidney & blood pressure research · 2026Article
- Combined lactate, base excess, and MEWS score as predictors of ICU transfer from the emergency department: a retrospective cohort study.Frontiers in medicine · 2026Article
- Peak Lactate Within 24 h and Mortality in Septic Shock Patients Receiving Continuous Renal Replacement Therapy: A Real-World Cohort from an Asian ICU (2018-2020).Life (Basel, Switzerland) · 2025Article
- Clinical characteristics and outcomes of patients with traumatic brain injury transferred from ultra-high-altitude areas: patient series.Journal of neurosurgery. Case lessons · 2025Article
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6 authors.
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Abstract
backgroundSevere hyperlactatemia (lactate level ≥ 10 mmol/L) is associated with high mortality rates in critically ill patients. However, there is limited data on emergency department (ED) patients. We aimed to investigate the clinical characteristics, etiology and outcomes of patients with severe hyperlactatemia in the ED setting.
methodsA retrospective cohort study was conducted at a tertiary care hospital in Thailand. We included adult patients with a venous lactate sample taken in the ED within one hour. We excluded patients after out-of-hospital cardiac arrest, transferred to/from another hospital or those with missing clinical data. Mortality rates were evaluated among patients with increasing degrees of lactate elevation and among patients with severe hyperlactatemia, stratified by causative etiology.
resultsWe analyzed venous lactate levels in 40,047 patients, with 26,680 included in the analysis. Among these, 1.7% had severe hyperlactatemia (lactate ≥ 10 mmol/L), 10.5% moderate (4-9.99 mmol/L), 28.8% mild (2-3.99 mmol/L), and 59.0% normal levels (< 2 mmol/L). Severe hyperlactatemia was associated with high mortality rates of 29%, 37%, and 38% at 7, 28, and 60 days respectively, significant ICU admissions and mechanical ventilation rates. Patients with severe hyperlactatemia were stratified into high (> 50% mortality), moderate (21-50%), and low (< 20%) 28-day mortality risk groups. High-risk conditions included non-septic shock, traumatic injuries/burns, and neurological issues, with mortality rates of 51.1%, 61.8%, and 57.1%, respectively. In the moderate risk group, namely infection without shock showed a high prevalence, with a mortality rate of 36%. In the low-risk group, seizures and fainting were associated with lower mortality, exhibiting mortality rates of 0%.
conclusionsSevere hyperlactatemia is associated with higher rates of ICU admission and mortality compared to other degrees of lactate elevation in a general ED population. However, mortality rates can vary considerably, depending on the underlying etiology associated with different primary diagnoses.
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