Association of Clinical Hypoperfusion Variables With Lactate Clearance and Hospital Mortality
| Autor: | Johana Ascuntar, Cesar Niño, Elisa Bernal, Carolina Hincapié, James Díaz, Jessica Londoño, Alba León, Jimmy León, Leonardo Mejía, Carlos Morales, Fabián Jaimes, Cesar Vargas |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Resuscitation Physical examination Critical Care and Intensive Care Medicine Logistic regression Infections 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Hyperlactatemia 030212 general & internal medicine Hospital Mortality Lactic Acid Prospective Studies Prospective cohort study Aged medicine.diagnostic_test Receiver operating characteristic business.industry Multiple Trauma 030208 emergency & critical care medicine Shock Middle Aged Capillary refill Pulse pressure Emergency Medicine Female business |
| Zdroj: | Shock (Augusta, Ga.). 50(3) |
| ISSN: | 1540-0514 |
| Popis: | BACKGROUND Lactate has shown utility in assessing the prognosis of patients admitted to the hospital with confirmed or suspected shock. Some findings of the physical examination may replace it as screening tool. We have determined the correlation and association between clinical perfusion parameters and lactate at the time of admission; the correlation between the change in clinical parameters and lactate clearance after 6 and 24 h of resuscitation; and the association between clinical parameters, lactate, and mortality. METHODS Prospective cohort study of adult patients hospitalized in the emergency room with infection, polytrauma, or other causes of hypotension. We measured serum lactate, capillary refill time, shock index, and pulse pressure at 0, 6, and 24 h after admission. A Spearman's correlation was performed between clinical variables and lactate levels, as well as between changes in clinical parameters and lactate clearance. The operative characteristics of these variables were determined by area under the receiver operating characteristic curve analysis and the association between lactate, clinical variables, and mortality through logistic regression. RESULTS A total of 1,320 patients met the inclusion criteria, 66.7% (n = 880) confirmed infection, 19% (n = 251) polytrauma, and 14.3% (n = 189) another etiology. No significant correlation was found between any clinical variable and lactate values (r |
| Databáze: | OpenAIRE |
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