PMID- 29602691 OWN - NLM STAT- MEDLINE DCOM- 20200609 LR - 20200609 IS - 1036-7314 (Print) IS - 1036-7314 (Linking) VI - 32 IP - 2 DP - 2019 Mar TI - The relationship between elevated prehospital point-of-care lactate measurements, intensive care unit admission, and mortality: A retrospective review of adult patients. PG - 100-105 LID - S1036-7314(17)30158-3 [pii] LID - 10.1016/j.aucc.2018.02.006 [doi] AB - OBJECTIVE: To determine whether prehospital point-of-care lactate (pLA) is associated with mortality, admission, and duration of hospital stay. DESIGN: A retrospective clinical audit, where elevated lactate was defined as >/=2 mmol/L. SETTING: The ambulance service and primary referral hospital in the Australian Capital Territory from 1st July 2014 to 30th June 2015. PARTICIPANTS: Adult patients (>/=18 years) who had pLA measured and were transported to the primary referral hospital. MAIN OUTCOME MEASURES: Mortality, admission, and duration of hospital stay. RESULTS: Two hundred fifty-three patients with a median pLA of 2.5 mmol/L (interquartile range [IQR]: 1.5-3.7) were analysed. Overall mortality was 8.3%; 68% were admitted to the hospital; 8.3% to the intensive care unit (ICU). pLA was non-significantly higher in those who died compared to survivors (3.5 [IQR: 2.75-5.85] vs 2.4 [1.5-3.6]; W = 1631.5; p = 0.053). pLA was higher for those admitted to the hospital (2.9 [1.9-3.9] vs 2.0 [1.4-3.1]; W = 5094.5, p = 0.001) and the ICU (3.2 [2.4-5.7] vs 2.4 [1.5-3.6]; W = 1578.5; p = 0.008). There was no relationship between pLA and duration of stay. Considered as a screening tool, at a cut-off of 2.5 mmol/L, pLA had a likelihood ratio+ of 1.61 for mortality and 1.44 for ICU admission; the odds ratio for mortality was 3.76 (95% confidence interval = 1.30, 13.89). CONCLUSIONS: Elevated prehospital lactate was associated with significantly increased ICU and hospital admissions. There may be value in pLA as a screening tool. CI - Copyright (c) 2018 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved. FAU - Swan, Kristi L AU - Swan KL AD - Australian National University Medical School, Florey Building, 54 Mills Road, Acton, Australian Capital Territory, Australia; Australian Capital Territory Ambulance Service, 9 Amberley Ave, Fairbairn Business Park, Majura, Australian Capital Territory, Australia. FAU - Avard, Bronwyn J AU - Avard BJ AD - The Canberra Hospital, Department of Intensive Care, Yamba Drive, Garran, Australian Capital Territory, Australia. FAU - Keene, Toby AU - Keene T AD - Australian Capital Territory Ambulance Service, 9 Amberley Ave, Fairbairn Business Park, Majura, Australian Capital Territory, Australia. Electronic address: toby.keene@act.gov.au. LA - eng PT - Journal Article DEP - 20180328 PL - Australia TA - Aust Crit Care JT - Australian critical care : official journal of the Confederation of Australian Critical Care Nurses JID - 9207852 RN - 0 (Biomarkers) RN - 0 (Lactates) MH - Adult MH - Aged MH - Aged, 80 and over MH - Australia MH - Biomarkers/blood MH - Emergency Medical Services MH - Female MH - *Hospital Mortality MH - Humans MH - Intensive Care Units/*statistics & numerical data MH - Lactates/*blood MH - Length of Stay/statistics & numerical data MH - Male MH - Middle Aged MH - Patient Admission/*statistics & numerical data MH - Point-of-Care Systems MH - Predictive Value of Tests MH - Retrospective Studies OTO - NOTNLM OT - Anaesthesia and intensive care OT - Emergency medicine OT - Emergency services-ambulance OT - Shock EDAT- 2018/04/01 06:00 MHDA- 2020/06/10 06:00 CRDT- 2018/04/01 06:00 PHST- 2017/03/05 00:00 [received] PHST- 2017/11/23 00:00 [revised] PHST- 2018/02/01 00:00 [accepted] PHST- 2018/04/01 06:00 [pubmed] PHST- 2020/06/10 06:00 [medline] PHST- 2018/04/01 06:00 [entrez] AID - S1036-7314(17)30158-3 [pii] AID - 10.1016/j.aucc.2018.02.006 [doi] PST - ppublish SO - Aust Crit Care. 2019 Mar;32(2):100-105. doi: 10.1016/j.aucc.2018.02.006. Epub 2018 Mar 28.