Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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Prognostic Value of Blood Lactate for Mortality of Acutely Poisoned Patients in Emergency Department

응급실내 급성 중독 환자들의 예후 예측에 대한 혈액 젖산 수치의 유용성

  • Kim, Hye Ran (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine) ;
  • Kang, Mun Ju (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine) ;
  • Kim, Yong Hwan (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine) ;
  • Lee, Jun Ho (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine) ;
  • Cho, Kwang Won (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine) ;
  • Hwang, Seong Youn (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine) ;
  • Lee, Dong Woo (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University, School of Medicine)
  • 김혜란 (성균관대학교 의과대학 삼성창원병원 응급의학과) ;
  • 강문주 (성균관대학교 의과대학 삼성창원병원 응급의학과) ;
  • 김용환 (성균관대학교 의과대학 삼성창원병원 응급의학과) ;
  • 이준호 (성균관대학교 의과대학 삼성창원병원 응급의학과) ;
  • 조광원 (성균관대학교 의과대학 삼성창원병원 응급의학과) ;
  • 황성연 (성균관대학교 의과대학 삼성창원병원 응급의학과) ;
  • 이동우 (성균관대학교 의과대학 삼성창원병원 응급의학과)
  • Received : 2016.05.12
  • Accepted : 2016.05.29
  • Published : 2016.06.30
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Abstract

Purpose: Patients suffering from acute poisoning by different substances often visit the emergency department (ED) and receive various prognoses according to the toxic material and patients' condition. Hyperlactatemia, which is an increased blood lactate level that generally indicates tissue hypoperfusion, is commonly utilized as a prognostic marker in critically ill patients such as those with sepsis. This study was conducted to investigate the relationships between blood lactate and clinical prognosis in acute poisoned patients. Methods: This retrospective study was conducted from January 2013 to June 2014 at a single and regional-tertiary ED. We enrolled study patients who were examined for blood test with lactate among acute intoxicated patients. The toxic materials, patient demographics, laboratory data, and mortalities were also reviewed. Additionally, we analyzed variables including blood lactate to verify the correlation with patient mortality. Results: A total of 531 patients were enrolled, including 24 (4.5%) non-survivors. Patient age, Glasgow coma scale (GCS), serum creatinine (Cr), aspartate transaminase (AST), and serum lactate differed significantly between survivors and non-survivors in the binary logistic regression analysis. Among these variables, GCS, AST, and lactate differed significantly. The median serum lactate levels were 2.0 mmol/L among survivors and 6.9 mmol/L among non-survivors. The AUC with the ROC curve and odds ratio of the initial serum lactate were 0.881 and 3.06 (0.89-8.64), respectively. Conclusion: Serum lactate was correlated with fatalities of acute poisoning patients in the ED; therefore, it may be used as a clinical predictor to anticipate their prognoses.

Keywords

References

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