Comparison between Capillary and Serum Lactate Levels in Predicting Short-Term Mortality of Septic Patients at the Emergency Department

Sepsis is a time-dependent and life-threating condition related to macro- and micro-circulatory impairment leading to anaerobic metabolism and lactate increase. We assessed the prognostic accuracy of capillary lactates (CLs) vs. serum ones (SLs) on 48-h and 7-day mortality in patients with suspected...

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Published in:International journal of molecular sciences 2023-05, Vol.24 (11), p.9121
Main Authors: Guarino, Matteo, Perna, Benedetta, Cesaro, Alice Eleonora, Spampinato, Michele Domenico, Previati, Rita, Costanzini, Anna, Maritati, Martina, Contini, Carlo, De Giorgio, Roberto
Format: Article
Language:English
Subjects:
Anaerobic conditions
Blood pressure
capillary lactates
Emergency medical care
Emergency medical services
Emergency service
Hospitals
Hypoxia
Informed consent
Lactates
Lactic acid
Metabolism
Mortality
Multivariate analysis
Sepsis
septic shock
serum lactates
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Summary:Sepsis is a time-dependent and life-threating condition related to macro- and micro-circulatory impairment leading to anaerobic metabolism and lactate increase. We assessed the prognostic accuracy of capillary lactates (CLs) vs. serum ones (SLs) on 48-h and 7-day mortality in patients with suspected sepsis. This observational, prospective, single-centre study was conducted between October 2021 and May 2022. Inclusion criteria were: (i) suspect of infection; (ii) qSOFA ≥ 2; (iii) age ≥ 18 years; (iv) signed informed consent. CLs were assessed with LactateProTM2 . 203 patients were included: 19 (9.3%) died within 48 h from admission to the Emergency Department, while 28 (13.8%) within 7 days. Patients deceased within 48 h (vs. survived) had higher CLs (19.3 vs. 5 mmol/L, < 0.001) and SLs (6.5 vs. 1.1 mmol/L, = 0.001). The best CLs predictive cut-off for 48-h mortality was 16.8 mmol/L (72.22% sensitivity, 94.02% specificity). Patients within 7 days had higher CLs (11.5 vs. 5 mmol/L, = 0.020) than SLs (2.75 vs. 1.1 mmol/L, < 0.001). The multivariate analysis confirmed CLs and SLs as independent predictors of 48-h and 7-day mortality. CLs can be a reliable tool for their inexpensiveness, rapidity and reliability in identifying septic patients at high risk of short-term mortality.
ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms24119121