High Plasma Lactate Levels Are Associated With Increased Risk of In-hospital Mortality in Patients With Pulmonary Embolism Full Text
Academic Emergency Medicine, 08/16/2011

Vanni S et al. – High plasma lactate was associated with increased in–hospital mortality in this sample of patients with acute pulmonary embolism (PE).

• This was a retrospective study at the emergency department (ED) of a third–level teaching hospital.
• The authors considered consecutive patients with a diagnosis of PE established by lung scan or spiral computed tomography (CT) and confirmed by pulmonary angiography if necessary.
• Only patients for whom plasma lactate levels had been tested within 6 hours from presentation to the ED were included.
• Primary outcome was in–hospital death due to any cause; secondary outcome was mortality related to PE.

• From September 1997 to June 2006, a total of 384 patients were diagnosed with PE in the ED.
• Of these patients, 287 had registered plasma lactate levels and were included in this analysis.
• Included patients had a mean age of 70 (SD ± 15 years, range=18 to 100 years), 163 (57%) were female, 26 (9%) showed systolic blood pressure lower than 100 mm Hg at presentation, and 160 (56%) had echocardiographic evidence of right ventricular dysfunction (RVD).
• Twenty patients died during their hospital stay (7%).
• Plasma lactate levels≥2 mmol/L were associated with in–hospital mortality from all causes (odds ratio [OR]=4.60, 95% confidence interval [CI]=1.57 to 13.53) and with PE–related mortality (OR=4.94, 95% CI=1.38 to 17.63), independent of hypotension or RVD at presentation.