Initial serum lactate level is associated with inpatient mortality in patients with community-acquired pneumonia

Min Hyuk Gwak, Sion Jo, Taeoh Jeong, Jae Baek Lee, Young Ho Jin, Jaechol Yoon, Boyoung Park

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Study objective: The aim of the present study was to investigate the prognostic value of the initial serum lactate level in patients with community-acquired pneumonia (CAP). Methods:Wecollected data on hospitalized adult patients with CAP via the study hospitalemergency department between October 2012 and September 2013. Demographics, comorbidities, and physiologic and laboratory variables including initial C-reactive protein (CRP) and serum lactate level were extracted from the electronic medical record. The primary outcome was inpatient mortality. Comparisons between survivors and nonsurvivors were performed, and multivariable logistic regression analyses were constructed as dependent variables of both continuous and categorical varieties. Results: A total of 397 patientswere enrolled, and themortality cases were 46 (11.6%). Themean lactate levelwas 1.7 ± 1.4 mmol/L and was significantly higher in the nonsurvivor group than in the survivor group (2.4 ± 2.2mmol/L vs 1.6±1.2mmol/L). In themultivariable logistic regression model for inpatientmortality constructed using lactate, CRP, and laboratory variables of pneumonia severity index (PSI), lactate and CRP remained as significant factors, but laboratory variables of PSI were not. In other multivariable logistic regression models for the outcome constructed using collected laboratory variables and PSI, lactate remained as a significant factor (adjusted odds ratio, 1.24; 95% confidence interval, 1.01-1.53; P = .042 by continuous variable; adjusted odds ratio of third tertile, 2.60; 95% confidence interval, 1.02-6.66; P =.046 by category variable). C-reactive protein and albumin were also left as significant factors. Conclusions: The initial serum lactate level is independently associated with mortality in hospitalized patients with CAP. However, laboratory variables of PSI or others were not, except CRP and albumin.

Original languageEnglish
Pages (from-to)685-690
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume33
Issue number5
DOIs
StatePublished - 2015 May 1

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Inpatients
Lactic Acid
Pneumonia
C-Reactive Protein
Mortality
Logistic Models
Serum
Survivors
Albumins
Odds Ratio
Confidence Intervals
Electronic Health Records
Comorbidity
Regression Analysis
Demography

Cite this

Gwak, Min Hyuk ; Jo, Sion ; Jeong, Taeoh ; Lee, Jae Baek ; Jin, Young Ho ; Yoon, Jaechol ; Park, Boyoung. / Initial serum lactate level is associated with inpatient mortality in patients with community-acquired pneumonia. In: American Journal of Emergency Medicine. 2015 ; Vol. 33, No. 5. pp. 685-690.
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abstract = "Study objective: The aim of the present study was to investigate the prognostic value of the initial serum lactate level in patients with community-acquired pneumonia (CAP). Methods:Wecollected data on hospitalized adult patients with CAP via the study hospitalemergency department between October 2012 and September 2013. Demographics, comorbidities, and physiologic and laboratory variables including initial C-reactive protein (CRP) and serum lactate level were extracted from the electronic medical record. The primary outcome was inpatient mortality. Comparisons between survivors and nonsurvivors were performed, and multivariable logistic regression analyses were constructed as dependent variables of both continuous and categorical varieties. Results: A total of 397 patientswere enrolled, and themortality cases were 46 (11.6{\%}). Themean lactate levelwas 1.7 ± 1.4 mmol/L and was significantly higher in the nonsurvivor group than in the survivor group (2.4 ± 2.2mmol/L vs 1.6±1.2mmol/L). In themultivariable logistic regression model for inpatientmortality constructed using lactate, CRP, and laboratory variables of pneumonia severity index (PSI), lactate and CRP remained as significant factors, but laboratory variables of PSI were not. In other multivariable logistic regression models for the outcome constructed using collected laboratory variables and PSI, lactate remained as a significant factor (adjusted odds ratio, 1.24; 95{\%} confidence interval, 1.01-1.53; P = .042 by continuous variable; adjusted odds ratio of third tertile, 2.60; 95{\%} confidence interval, 1.02-6.66; P =.046 by category variable). C-reactive protein and albumin were also left as significant factors. Conclusions: The initial serum lactate level is independently associated with mortality in hospitalized patients with CAP. However, laboratory variables of PSI or others were not, except CRP and albumin.",
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Initial serum lactate level is associated with inpatient mortality in patients with community-acquired pneumonia. / Gwak, Min Hyuk; Jo, Sion; Jeong, Taeoh; Lee, Jae Baek; Jin, Young Ho; Yoon, Jaechol; Park, Boyoung.

In: American Journal of Emergency Medicine, Vol. 33, No. 5, 01.05.2015, p. 685-690.

Research output: Contribution to journalArticle

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AU - Jin, Young Ho

AU - Yoon, Jaechol

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N2 - Study objective: The aim of the present study was to investigate the prognostic value of the initial serum lactate level in patients with community-acquired pneumonia (CAP). Methods:Wecollected data on hospitalized adult patients with CAP via the study hospitalemergency department between October 2012 and September 2013. Demographics, comorbidities, and physiologic and laboratory variables including initial C-reactive protein (CRP) and serum lactate level were extracted from the electronic medical record. The primary outcome was inpatient mortality. Comparisons between survivors and nonsurvivors were performed, and multivariable logistic regression analyses were constructed as dependent variables of both continuous and categorical varieties. Results: A total of 397 patientswere enrolled, and themortality cases were 46 (11.6%). Themean lactate levelwas 1.7 ± 1.4 mmol/L and was significantly higher in the nonsurvivor group than in the survivor group (2.4 ± 2.2mmol/L vs 1.6±1.2mmol/L). In themultivariable logistic regression model for inpatientmortality constructed using lactate, CRP, and laboratory variables of pneumonia severity index (PSI), lactate and CRP remained as significant factors, but laboratory variables of PSI were not. In other multivariable logistic regression models for the outcome constructed using collected laboratory variables and PSI, lactate remained as a significant factor (adjusted odds ratio, 1.24; 95% confidence interval, 1.01-1.53; P = .042 by continuous variable; adjusted odds ratio of third tertile, 2.60; 95% confidence interval, 1.02-6.66; P =.046 by category variable). C-reactive protein and albumin were also left as significant factors. Conclusions: The initial serum lactate level is independently associated with mortality in hospitalized patients with CAP. However, laboratory variables of PSI or others were not, except CRP and albumin.

AB - Study objective: The aim of the present study was to investigate the prognostic value of the initial serum lactate level in patients with community-acquired pneumonia (CAP). Methods:Wecollected data on hospitalized adult patients with CAP via the study hospitalemergency department between October 2012 and September 2013. Demographics, comorbidities, and physiologic and laboratory variables including initial C-reactive protein (CRP) and serum lactate level were extracted from the electronic medical record. The primary outcome was inpatient mortality. Comparisons between survivors and nonsurvivors were performed, and multivariable logistic regression analyses were constructed as dependent variables of both continuous and categorical varieties. Results: A total of 397 patientswere enrolled, and themortality cases were 46 (11.6%). Themean lactate levelwas 1.7 ± 1.4 mmol/L and was significantly higher in the nonsurvivor group than in the survivor group (2.4 ± 2.2mmol/L vs 1.6±1.2mmol/L). In themultivariable logistic regression model for inpatientmortality constructed using lactate, CRP, and laboratory variables of pneumonia severity index (PSI), lactate and CRP remained as significant factors, but laboratory variables of PSI were not. In other multivariable logistic regression models for the outcome constructed using collected laboratory variables and PSI, lactate remained as a significant factor (adjusted odds ratio, 1.24; 95% confidence interval, 1.01-1.53; P = .042 by continuous variable; adjusted odds ratio of third tertile, 2.60; 95% confidence interval, 1.02-6.66; P =.046 by category variable). C-reactive protein and albumin were also left as significant factors. Conclusions: The initial serum lactate level is independently associated with mortality in hospitalized patients with CAP. However, laboratory variables of PSI or others were not, except CRP and albumin.

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