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EMJ Online First, published on January 19, 2015 as 10.1136/emermed-2013-203541 Original article

Arterial lactate levels in an emergency department are associated with mortality: a prospective observational cohort study Deepankar Datta,1 Craig Walker,1,2 Alasdair James Gray,1 Catriona Graham3 ▸ Additional material is published online only. To view please visit the journal online (http://dx.doi.org/10.1136/ emermed-2013-203541). 1

Emergency Medicine Research Group Edinburgh (EMeRGE), Department of Emergency Medicine, Royal Infirmary of Edinburgh (NHS Lothian), Little France Crescent, Edinburgh, UK 2 Critical Care Department, St John’s Hospital (NHS Lothian), Livingston, UK 3 Wellcome Trust Clinical Research Facility, Western General Hospital, University of Edinburgh, Edinburgh, UK Correspondence to Dr Deepankar Datta, Emergency Medicine Research Group Edinburgh (EMeRGE), Department of Emergency Medicine, Royal Infirmary of Edinburgh (NHS Lothian), Little France Crescent, Edinburgh, Scotland, EH16 4SA, UK; [email protected] Received 28 December 2013 Revised 27 November 2014 Accepted 28 November 2014

ABSTRACT Objectives Lactate measurements are routinely carried out in emergency departments and are associated with increased mortality in septic patients. However, no definitive research has been carried out into whether lactate measurements can be used as a prognostic marker in a clinically unwell population in the emergency department. Methods We carried out a prospective observational cohort study in consecutive patients whose arterial lactate concentration was measured in the emergency department of a tertiary referral hospital assessing 110 000 patients per year between 11th May and 11th August 2011. The main outcome measure was 30-day mortality. Results There were 120 deaths (16.1%) at 30 days postattendance in our cohort of 747 patients. Multivariate logistic regression revealed lower lactate levels were associated with 30-day survival: ORs for 30-day death compared with lactate ≥4 were 0.125 (95% CI 0.068 to 0.229) for lactate

Arterial lactate levels in an emergency department are associated with mortality: a prospective observational cohort study.

Lactate measurements are routinely carried out in emergency departments and are associated with increased mortality in septic patients. However, no de...
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