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Does Lactate Clearance Predict Short-Term Mortality in Pulmonary Embolism?

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Abstract

Plasma lactate level of ≥ 2 mmol/L can predict pulmonary embolism (PE)-associated adverse outcomes but has led to the question of if monitoring lactate concentration can be more reliable than the adequacy of a single measurement. It could be more beneficial to use repeated assessments of lactate concentration to forecast results in this patient group. This study aims to investigate the predictive value of lactate clearance (LC) in short-term mortality in patients diagnosed with PE in the emergency department (ED). A prospective cross-sectional study was conducted in ED of a tertiary care hospital. Patients who were diagnosed with PE over age 18 were enrolled in the study. The risk factors, vital signs, and lactate levels (at arrival and the 2nd hour) at admission were recorded. The Pulmonary Embolism Severity Index (PESI) scores of the patients were calculated. The 24-h, 7-d, and 30-d survival rates of the patients were evaluated. Then, 77 patients were included in the study. PESI score, basal, and 2nd-hour lactate levels were found significant in predicting 30-day mortality (p = 0.002, 0.009, and 0.002, respectively). Receiver operating characteristic (ROC) curve analyses for PESI, basal, and 2nd-hour lactate levels showed an area under curve (AUC) of 0.703 (95% CI: 0.586–0.820), 0.688 (95% CI: 0.552–0.824), and 0.722 (95% CI: 0.586–0.857), respectively. The predictive performances of PESI, basal, and 2nd-hour lactate level were similar. LC was not significant in predicting the 30-day mortality (p = 0.290). LC was not correlated with mortality in patients with PE.

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Data Availability

Data will be made available on reasonable request.

Code Availability

Not applicable.

Abbreviations

ED :

Emergency department

PE :

Pulmonary embolism

LC :

Lactate clearance

PESI :

Pulmonary Embolism Severity Index

ROC :

Receiver operating characteristic

AUC :

Area under curve

PERC :

Pulmonary embolism rule-out criteria

HIMS :

Hospital ınformation management system

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Authors and Affiliations

  1. Department of Emergency Medicine, Tavşanlı State Hospital, Kütahya, Turkey

    Yavuz Selim Benzer

  2. Department of Emergency Medicine, Etlik City Hospital, Ankara, Turkey

    Gülşen Çığşar

  3. Department of Emergency Medicine, University of Health Sciences, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

    Bedriye Müge Sönmez

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  1. Yavuz Selim Benzer
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  2. Gülşen Çığşar
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  3. Bedriye Müge Sönmez
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Contributions

YSB: software (lead) and writing, review, and editing (equal); GÇ: methodology (lead) and writing—review and editing (equal); and BMS: conceptualization (lead), writing—original draft (lead), formal analysis (lead), and writing—review and editing (equal).

Corresponding author

Correspondence to Bedriye Müge Sönmez.

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Ethics Approval

The study was approved by the Institutional Review Board of the Ethics Committee of the University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital (decision date: 10.08.2020, decision no: 93/09).

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Written informed consent was obtained from all of them or their first-degree relatives before the procedures in line with the criteria of the Helsinki Declaration (2013).

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All authors agreed to publish this manuscript.

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Benzer, Y.S., Çığşar, G. & Sönmez, B.M. Does Lactate Clearance Predict Short-Term Mortality in Pulmonary Embolism?. SN Compr. Clin. Med. 6, 46 (2024). https://doi.org/10.1007/s42399-024-01671-9

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