Evidence map›Paper›PMID 39741239›Full record

ArticleInternational journal of emergency medicine2024

Examining the association of elevated initial serum lactate with mortality and morbidity in trauma patients: a retrospective study.

Pablo Rodríguez-Ortiz, Kyara Berríos-Toledo, Ediel O Ramos-Meléndez, Lourdes Guerrios-Rivera

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Article in International journal of emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Pablo Rodríguez-OrtizTrauma Research Program, School of Medicine, Department of Surgery, University of Puerto Rico, Medical Sciences Campus, P.O. Box 365067, San Juan, 00967, Puerto Rico.
Kyara Berríos-ToledoTrauma Research Program, School of Medicine, Department of Surgery, University of Puerto Rico, Medical Sciences Campus, P.O. Box 365067, San Juan, 00967, Puerto Rico. kyara.berrios@upr.edu.ORCID https://orcid.org/0009-0007-3426-0432
Ediel O Ramos-MeléndezTrauma Research Program, School of Medicine, Department of Surgery, University of Puerto Rico, Medical Sciences Campus, P.O. Box 365067, San Juan, 00967, Puerto Rico.ORCID https://orcid.org/0000-0002-2595-8018
Lourdes Guerrios-RiveraTrauma Research Program, School of Medicine, Department of Surgery, University of Puerto Rico, Medical Sciences Campus, P.O. Box 365067, San Juan, 00967, Puerto Rico.ORCID https://orcid.org/0000-0003-3846-5105

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElevated initial serum lactate (iSL) levels are frequently employed to assess trauma severity, but their predictive value for mortality and morbidity remains inconsistent. We evaluated the association of iSL with mortality and morbidity at Puerto Rico Trauma Hospital (PRTH).

methodsThis IRB-approved retrospective study included trauma patients ≥ 18 years with iSL measured within the first 48 h of admission to PRTH (July 2014-June 2019). Patients were classified as normal (4.5-19.8 mg/dL) or elevated (≥ 19.9 mg/dL) iSL levels. Group comparisons were conducted using t-tests, Wilcoxon rank-sum tests, Pearson's chi-squared, or Fisher's exact tests. Associations were evaluated with regression and ROC analyses.

resultsAmong 536 patients, 54.3% had elevated iSL levels. Initially, elevated iSL was associated with in-hospital mortality (OR: 2.18, 95%CI: 1.36-3.51, p < 0.001), traumatic intensive care unit (TICU) admission (OR: 2.06, 95%CI: 1.46-2.92, p < 0.001), and need for mechanical ventilation (MV) (OR: 2.80, 95%CI: 1.97-3.98, p < 0.001). However, adjusted analyses showed no significant associations (Mortality-AOR: 1.72, 95%CI: 0.97-3.04, p = 0.06; TICU-AOR: 1.11, 95%CI: 0.71-1.75, p = 0.65; MV-AOR: 1.49, 95%CI: 0.89-2.49, p = 0.13). Both iSL (AUC: 0.59, 95%CI: 0.54-0.64) and ISS (AUC: 0.59, 95%CI: 0.54-0.64) demonstrated limited ability to predict mortality, with no statistically significant difference between them (p > 0.99). Patients with elevated iSL experienced prolonged hospital and TICU stays and severe injuries.

conclusionsElevated iSL levels may not independently predict mortality, TICU admission, or the need for MV in trauma patients. However, their rapid availability supports their use alongside other clinical markers to guide trauma care decision-making and improve trauma outcomes.

Indexed as

In-hospital mortalityInitial serum lactate levelIntensive careMechanical ventilationTrauma patient

Identifiers

PMID39741239
PMCPMC11687188

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.