The timing of last hemodialysis influences the prognostic value of serum lactate levels in predicting mortality of end-stage renal disease patients with sepsis in the emergency department
| Autor: | Fu Cheng Chen, Chia Te Kung, Chun Chieh Chu, Hsien Hung Cheng, Chih Min Su, Chi Yung Cheng |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Observational Study Group B End stage renal disease Sepsis sepsis 03 medical and health sciences symbols.namesake 0302 clinical medicine Predictive Value of Tests Renal Dialysis Internal medicine Medicine Humans 030212 general & internal medicine Hospital Mortality Lactic Acid Fisher's exact test Aged Retrospective Studies lactate hemodialysis business.industry Retrospective cohort study General Medicine Emergency department Middle Aged medicine.disease mortality ROC Curve 030220 oncology & carcinogenesis Predictive value of tests symbols Kidney Failure Chronic Female Hemodialysis business Emergency Service Hospital Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 0025-7974 |
| Popis: | Sepsis is a life-threatening condition, and serum lactate levels have been used to predict patient prognosis. Studies on serum lactate levels in patients undergoing regular hemodialysis who have sepsis are limited. This study aimed to determine the predictive value of serum lactate levels for sepsis-related mortality among patients who underwent last hemodialysis at three different times before admission to the emergency department (ED). This retrospective cohort study was conducted from January 2007 to December 2013 in southern Taiwan. All hemodialysis patients with sepsis, receiving antibiotics within 24 hours of sepsis confirmation, admitted for at least 3 days, and whose serum lactate levels were known were examined to determine the difference in the serum lactate levels of patients who underwent last hemodialysis within 4 hours (Groups A), in 4–12 hours (Group B), and beyond 12 hours (Group C) before visited to the ED. All the continuous variables, categorical variables and mortality were compared by using Kruskal-Wallis test or Mann-Whitney test, the χ2 or Fisher exact tests, and multiple logistic regression model, respectively. A total of 490 patients were enrolled in the study, and 8.0% (39), 21.5% (84), and 74.9% (367) of the patients were in Group A, Group B and Group C, respectively; the serum lactate levels (2.91 vs 2.13 vs 2.79 mmol/L, respectively; P = .175) and 28-day in-hospital mortality (17.9% vs 14.6% vs 22.9%) showed no statistically significant difference between 3 groups. The association between serum lactate levels and 28-day in-hospital mortality was reliable in Group B (P = .002) and Group C (P |
| Databáze: | OpenAIRE |
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