Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Leung LY(1), Hung KKC(1)(2), Cho C(1), Graham CA(1)(2), Man SY(1)(2)
Affiliation :
(1) Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR (2) Emergency Medicine Research Unit, Accident and Emergency Department, Prince of Wales Hospital, Shatin, Hong Kong SAR
Introduction :
High venous blood lactate (VBL) levels are linked to poor patient outcomes. It is commonly measured in the emergency department (ED) for prognostic prediction.
Objectives :
To investigate the prognostic value of VBL level for ED patients and to determine if this value varies with age.
Methodology :
This prospective study was conducted at Prince of Wales Hospital ED from July 2016 to June 2017. Patients triaged as category 2 (Emergency) and 3 (Urgent) were recruited. A Blood Gas Analyzer measured the VBL levels for these patients. The primary outcome was the 30-day all-cause mortality. The Receiver Operating Characteristic Curve was used to determine the prognostic value of VBL in predicting 30-day all-cause mortality.
Result & Outcome :
A total of 1253 patients were recruited in the study; 50.9% were male, and the median age was 72 years. VBL levels were available for 1248 patients (99.6%). High VBL levels (≥2 mmol/L) were found in 34.8% of all patients. The 30-day all-cause mortality rate was 5.7% for all patients, 2.8% for patients aged<65 and 6.9% for patients aged ≥65 years. The AUC values for predicting 30-day all-cause mortality were 0.71 (95%CI 0.64 to 0.78) for all patients, 0.85 (95%CI 0.81 to 0.88) for aged <65 years, and 0.67 (95%CI 0.64 to 0.70) for aged ≥65 years. Conclusion: The VBL level is a reliable predictor for 30-day all-cause mortality of ED patients and is more accurate in younger patients.
