Diagnostic performance of initial serum lactate for predicting bacteremia in female patients with acute pyelonephritis

Dong Young Seo, Sion Jo, Jae Baek Lee, Young Ho Jin, Taeoh Jeong, Jaechol Yoon, Boyoung Park

Research output: Contribution to journalArticle

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Abstract

Objectives The purpose of the present study was to investigate the diagnostic value of lactate for predicting bacteremia in female patients with acute pyelonephritis (APN). Methods We conducted a retrospective study of female patients with APN who visited the study hospital emergency department. The demographics, comorbidities, physiologies, and laboratory variables including white blood cell count and segmented neutrophil count, C-reactive protein, and initial serum lactate levels were collected and analyzed to identify associations with the presence of bacteremia. Results During the study period, a total of 314 patients were enrolled. One hundred twenty-three patients (39.2%) had bacteremia. Escherichia coli was the most frequent pathogen. Logistic regression analysis demonstrated that the lactate level was independently associated with the presence of bacteremia (odds ratio, 1.39 [95% confidence interval, 1.08-1.78]). The C-statistic of the lactate level was 0.67 (95% CI, 0.60-0.73). At a cutoff value of 1.4 mmol/L, the lactate level predicted bacteremia with a sensitivity (53.7%), specificity (72.3%), positive predictive value (55.5%), negative predictive value (70.8%), positive likelihood ratio (1.93), and negative likelihood ratio (0.64). Conclusion The initial serum lactate level showed poor discriminative performance for predicting bacteremia in female patients with APN.

Original languageEnglish
Pages (from-to)1359-1363
Number of pages5
JournalAmerican Journal of Emergency Medicine
Volume34
Issue number8
DOIs
StatePublished - 2016 Aug 1

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Pyelonephritis
Bacteremia
Lactic Acid
Serum
Hospital Departments
Leukocyte Count
C-Reactive Protein
Hospital Emergency Service
Comorbidity
Neutrophils
Retrospective Studies
Logistic Models
Odds Ratio
Regression Analysis
Demography
Confidence Intervals
Escherichia coli
Sensitivity and Specificity

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Seo, Dong Young ; Jo, Sion ; Lee, Jae Baek ; Jin, Young Ho ; Jeong, Taeoh ; Yoon, Jaechol ; Park, Boyoung. / Diagnostic performance of initial serum lactate for predicting bacteremia in female patients with acute pyelonephritis. In: American Journal of Emergency Medicine. 2016 ; Vol. 34, No. 8. pp. 1359-1363.
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abstract = "Objectives The purpose of the present study was to investigate the diagnostic value of lactate for predicting bacteremia in female patients with acute pyelonephritis (APN). Methods We conducted a retrospective study of female patients with APN who visited the study hospital emergency department. The demographics, comorbidities, physiologies, and laboratory variables including white blood cell count and segmented neutrophil count, C-reactive protein, and initial serum lactate levels were collected and analyzed to identify associations with the presence of bacteremia. Results During the study period, a total of 314 patients were enrolled. One hundred twenty-three patients (39.2{\%}) had bacteremia. Escherichia coli was the most frequent pathogen. Logistic regression analysis demonstrated that the lactate level was independently associated with the presence of bacteremia (odds ratio, 1.39 [95{\%} confidence interval, 1.08-1.78]). The C-statistic of the lactate level was 0.67 (95{\%} CI, 0.60-0.73). At a cutoff value of 1.4 mmol/L, the lactate level predicted bacteremia with a sensitivity (53.7{\%}), specificity (72.3{\%}), positive predictive value (55.5{\%}), negative predictive value (70.8{\%}), positive likelihood ratio (1.93), and negative likelihood ratio (0.64). Conclusion The initial serum lactate level showed poor discriminative performance for predicting bacteremia in female patients with APN.",
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Diagnostic performance of initial serum lactate for predicting bacteremia in female patients with acute pyelonephritis. / Seo, Dong Young; Jo, Sion; Lee, Jae Baek; Jin, Young Ho; Jeong, Taeoh; Yoon, Jaechol; Park, Boyoung.

In: American Journal of Emergency Medicine, Vol. 34, No. 8, 01.08.2016, p. 1359-1363.

Research output: Contribution to journalArticle

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T1 - Diagnostic performance of initial serum lactate for predicting bacteremia in female patients with acute pyelonephritis

AU - Seo, Dong Young

AU - Jo, Sion

AU - Lee, Jae Baek

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AU - Jeong, Taeoh

AU - Yoon, Jaechol

AU - Park, Boyoung

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N2 - Objectives The purpose of the present study was to investigate the diagnostic value of lactate for predicting bacteremia in female patients with acute pyelonephritis (APN). Methods We conducted a retrospective study of female patients with APN who visited the study hospital emergency department. The demographics, comorbidities, physiologies, and laboratory variables including white blood cell count and segmented neutrophil count, C-reactive protein, and initial serum lactate levels were collected and analyzed to identify associations with the presence of bacteremia. Results During the study period, a total of 314 patients were enrolled. One hundred twenty-three patients (39.2%) had bacteremia. Escherichia coli was the most frequent pathogen. Logistic regression analysis demonstrated that the lactate level was independently associated with the presence of bacteremia (odds ratio, 1.39 [95% confidence interval, 1.08-1.78]). The C-statistic of the lactate level was 0.67 (95% CI, 0.60-0.73). At a cutoff value of 1.4 mmol/L, the lactate level predicted bacteremia with a sensitivity (53.7%), specificity (72.3%), positive predictive value (55.5%), negative predictive value (70.8%), positive likelihood ratio (1.93), and negative likelihood ratio (0.64). Conclusion The initial serum lactate level showed poor discriminative performance for predicting bacteremia in female patients with APN.

AB - Objectives The purpose of the present study was to investigate the diagnostic value of lactate for predicting bacteremia in female patients with acute pyelonephritis (APN). Methods We conducted a retrospective study of female patients with APN who visited the study hospital emergency department. The demographics, comorbidities, physiologies, and laboratory variables including white blood cell count and segmented neutrophil count, C-reactive protein, and initial serum lactate levels were collected and analyzed to identify associations with the presence of bacteremia. Results During the study period, a total of 314 patients were enrolled. One hundred twenty-three patients (39.2%) had bacteremia. Escherichia coli was the most frequent pathogen. Logistic regression analysis demonstrated that the lactate level was independently associated with the presence of bacteremia (odds ratio, 1.39 [95% confidence interval, 1.08-1.78]). The C-statistic of the lactate level was 0.67 (95% CI, 0.60-0.73). At a cutoff value of 1.4 mmol/L, the lactate level predicted bacteremia with a sensitivity (53.7%), specificity (72.3%), positive predictive value (55.5%), negative predictive value (70.8%), positive likelihood ratio (1.93), and negative likelihood ratio (0.64). Conclusion The initial serum lactate level showed poor discriminative performance for predicting bacteremia in female patients with APN.

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