The Prognostic Value of Prehospital Blood Lactate Levels to Predict Early Mortality in Acute Cardiovascular Disease
INTRODUCTION:The knowledge of the prognostic value of prehospital lactate (PLA) is limited. Our objective was to evaluate the predictive capacity of PLA to predict early mortality (within 48 h) from the index event in acute cardiovascular disease (ACVD). METHODS:Prospective, longitudinal, multicente...
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| Veröffentlicht in: | Shock (Augusta, Ga.) Ga.), 2020-02, Vol.53 (2), p.164-170 |
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| creator | Martín-Rodríguez, Francisco López-Izquierdo, Raúl Castro Villamor, Miguel A. del Pozo Vegas, Carlos Delgado Benito, María del Pilar Martínez Caballero, Carmen M. Priego Martínez, Vicente Martín Conty, José Luis Mayo-Iscar, Agustín Sánchez-Soberón, Irene Baez, Gemma Pastor |
| description | INTRODUCTION:The knowledge of the prognostic value of prehospital lactate (PLA) is limited. Our objective was to evaluate the predictive capacity of PLA to predict early mortality (within 48 h) from the index event in acute cardiovascular disease (ACVD).
METHODS:Prospective, longitudinal, multicenter, observational study in patients, attended by advanced life support units, transferred to the emergency department of their reference hospital and diagnosed with ACVD. We collected demographic, physiological, clinical, analytical variables, main cardiological diagnosis, and data on hospital admission and early mortality. The main outcome variable was mortality from any cause within 2 days.
RESULTS:Between March 1, 2018 and January 31, 2019, a total of 492 patients were included in our study. Early mortality after the index event within the first 48 h affected 27 patients (5.5%). The most frequent cause of care demand was chest pain with 223 cases (45.3%). The predictive power of PLA to discriminate mortality at 2 days obtained an area under the curve of 0.911 (95% confidence interval [CI]0.83–0.98, P |
| doi_str_mv | 10.1097/SHK.0000000000001356 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1097_SHK_0000000000001356</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>30998648</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4016-7f75f4069f5bd011dc54eaef84056ffbc9b902bfaa291447c7e46846d352d1503</originalsourceid><addsrcrecordid>eNqFkdlKBDEQRYMo7n8gkh9oraSTXh51XHFEweW1SacrTms0Q5JW5u_NOCrigxYFVRTn3odbhOww2GNQl_s3Zxd78KNYLoslss6kgAwkE8tphzLPeM75GtkI4RGAi7wuV8laDnVdFaJaJ-F2gvTau4cXF2Kv6b2yA1Jn0g0nLkz7qCw9tM51dKx0VBHpGF_RBhrdnOl6Hemx8nZGL51PcB9ntH-hB3pI6Ej5rnevKujBKk-P-oAq4BZZMcoG3P6cm-Tu5Ph2dJaNr07PRwfjTAtgRVaaUhoBRW1k2wFjnZYCFZpKgCyMaXXd1sBboxSvmRClLlEUlSi6XPKOScg3iVj4au9C8Giaqe-flZ81DJp5hk3KsPmdYZLtLmTToX3G7lv0FVoCqgXw5mxEH57s8Ia-maCycfKft_hDCh8fqnjGgcO80ydTyfwd1d2OLg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>The Prognostic Value of Prehospital Blood Lactate Levels to Predict Early Mortality in Acute Cardiovascular Disease</title><source>MEDLINE</source><source>Journals@Ovid LWW Legacy Archive</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Martín-Rodríguez, Francisco ; López-Izquierdo, Raúl ; Castro Villamor, Miguel A. ; del Pozo Vegas, Carlos ; Delgado Benito, María del Pilar ; Martínez Caballero, Carmen M. ; Priego Martínez, Vicente ; Martín Conty, José Luis ; Mayo-Iscar, Agustín ; Sánchez-Soberón, Irene ; Baez, Gemma Pastor</creator><creatorcontrib>Martín-Rodríguez, Francisco ; López-Izquierdo, Raúl ; Castro Villamor, Miguel A. ; del Pozo Vegas, Carlos ; Delgado Benito, María del Pilar ; Martínez Caballero, Carmen M. ; Priego Martínez, Vicente ; Martín Conty, José Luis ; Mayo-Iscar, Agustín ; Sánchez-Soberón, Irene ; Baez, Gemma Pastor</creatorcontrib><description>INTRODUCTION:The knowledge of the prognostic value of prehospital lactate (PLA) is limited. Our objective was to evaluate the predictive capacity of PLA to predict early mortality (within 48 h) from the index event in acute cardiovascular disease (ACVD).
METHODS:Prospective, longitudinal, multicenter, observational study in patients, attended by advanced life support units, transferred to the emergency department of their reference hospital and diagnosed with ACVD. We collected demographic, physiological, clinical, analytical variables, main cardiological diagnosis, and data on hospital admission and early mortality. The main outcome variable was mortality from any cause within 2 days.
RESULTS:Between March 1, 2018 and January 31, 2019, a total of 492 patients were included in our study. Early mortality after the index event within the first 48 h affected 27 patients (5.5%). The most frequent cause of care demand was chest pain with 223 cases (45.3%). The predictive power of PLA to discriminate mortality at 2 days obtained an area under the curve of 0.911 (95% confidence interval [CI]0.83–0.98, P < 0.001). A value equal or superior to 4.3 mmol/L globally attained a sensitivity of 92.6% (95% CI, 76.6–97.9) with a specificity of 82.8% (95% CI, 79.1–86.0), with a positive predictive value of 23.8 (16.7–32.8) and a negative predictive value of 99.5 (98.1–99.9).
CONCLUSION:PLA represents a prognostic biomarker with excellent predictive capacity for ACVD. Prehospital Emergency Services (PhEMS) should incorporate this test routinely in their usual procedures.</description><identifier>ISSN: 1073-2322</identifier><identifier>EISSN: 1540-0514</identifier><identifier>DOI: 10.1097/SHK.0000000000001356</identifier><identifier>PMID: 30998648</identifier><language>eng</language><publisher>United States: by the Shock Society</publisher><subject>Acute Disease - mortality ; Aged ; Aged, 80 and over ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - pathology ; Emergency Medical Services ; Female ; Humans ; Lactic Acid - blood ; Male ; Middle Aged ; Multicenter Studies as Topic ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; ROC Curve</subject><ispartof>Shock (Augusta, Ga.), 2020-02, Vol.53 (2), p.164-170</ispartof><rights>by the Shock Society</rights><rights>2020 by the Shock Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4016-7f75f4069f5bd011dc54eaef84056ffbc9b902bfaa291447c7e46846d352d1503</citedby><cites>FETCH-LOGICAL-c4016-7f75f4069f5bd011dc54eaef84056ffbc9b902bfaa291447c7e46846d352d1503</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00024382-202002000-00005$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>314,776,780,4595,27901,27902,65434</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30998648$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martín-Rodríguez, Francisco</creatorcontrib><creatorcontrib>López-Izquierdo, Raúl</creatorcontrib><creatorcontrib>Castro Villamor, Miguel A.</creatorcontrib><creatorcontrib>del Pozo Vegas, Carlos</creatorcontrib><creatorcontrib>Delgado Benito, María del Pilar</creatorcontrib><creatorcontrib>Martínez Caballero, Carmen M.</creatorcontrib><creatorcontrib>Priego Martínez, Vicente</creatorcontrib><creatorcontrib>Martín Conty, José Luis</creatorcontrib><creatorcontrib>Mayo-Iscar, Agustín</creatorcontrib><creatorcontrib>Sánchez-Soberón, Irene</creatorcontrib><creatorcontrib>Baez, Gemma Pastor</creatorcontrib><title>The Prognostic Value of Prehospital Blood Lactate Levels to Predict Early Mortality in Acute Cardiovascular Disease</title><title>Shock (Augusta, Ga.)</title><addtitle>Shock</addtitle><description>INTRODUCTION:The knowledge of the prognostic value of prehospital lactate (PLA) is limited. Our objective was to evaluate the predictive capacity of PLA to predict early mortality (within 48 h) from the index event in acute cardiovascular disease (ACVD).
METHODS:Prospective, longitudinal, multicenter, observational study in patients, attended by advanced life support units, transferred to the emergency department of their reference hospital and diagnosed with ACVD. We collected demographic, physiological, clinical, analytical variables, main cardiological diagnosis, and data on hospital admission and early mortality. The main outcome variable was mortality from any cause within 2 days.
RESULTS:Between March 1, 2018 and January 31, 2019, a total of 492 patients were included in our study. Early mortality after the index event within the first 48 h affected 27 patients (5.5%). The most frequent cause of care demand was chest pain with 223 cases (45.3%). The predictive power of PLA to discriminate mortality at 2 days obtained an area under the curve of 0.911 (95% confidence interval [CI]0.83–0.98, P < 0.001). A value equal or superior to 4.3 mmol/L globally attained a sensitivity of 92.6% (95% CI, 76.6–97.9) with a specificity of 82.8% (95% CI, 79.1–86.0), with a positive predictive value of 23.8 (16.7–32.8) and a negative predictive value of 99.5 (98.1–99.9).
CONCLUSION:PLA represents a prognostic biomarker with excellent predictive capacity for ACVD. Prehospital Emergency Services (PhEMS) should incorporate this test routinely in their usual procedures.</description><subject>Acute Disease - mortality</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiovascular Diseases - blood</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cardiovascular Diseases - pathology</subject><subject>Emergency Medical Services</subject><subject>Female</subject><subject>Humans</subject><subject>Lactic Acid - blood</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multicenter Studies as Topic</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>ROC Curve</subject><issn>1073-2322</issn><issn>1540-0514</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkdlKBDEQRYMo7n8gkh9oraSTXh51XHFEweW1SacrTms0Q5JW5u_NOCrigxYFVRTn3odbhOww2GNQl_s3Zxd78KNYLoslss6kgAwkE8tphzLPeM75GtkI4RGAi7wuV8laDnVdFaJaJ-F2gvTau4cXF2Kv6b2yA1Jn0g0nLkz7qCw9tM51dKx0VBHpGF_RBhrdnOl6Hemx8nZGL51PcB9ntH-hB3pI6Ej5rnevKujBKk-P-oAq4BZZMcoG3P6cm-Tu5Ph2dJaNr07PRwfjTAtgRVaaUhoBRW1k2wFjnZYCFZpKgCyMaXXd1sBboxSvmRClLlEUlSi6XPKOScg3iVj4au9C8Giaqe-flZ81DJp5hk3KsPmdYZLtLmTToX3G7lv0FVoCqgXw5mxEH57s8Ia-maCycfKft_hDCh8fqnjGgcO80ydTyfwd1d2OLg</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Martín-Rodríguez, Francisco</creator><creator>López-Izquierdo, Raúl</creator><creator>Castro Villamor, Miguel A.</creator><creator>del Pozo Vegas, Carlos</creator><creator>Delgado Benito, María del Pilar</creator><creator>Martínez Caballero, Carmen M.</creator><creator>Priego Martínez, Vicente</creator><creator>Martín Conty, José Luis</creator><creator>Mayo-Iscar, Agustín</creator><creator>Sánchez-Soberón, Irene</creator><creator>Baez, Gemma Pastor</creator><general>by the Shock Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20200201</creationdate><title>The Prognostic Value of Prehospital Blood Lactate Levels to Predict Early Mortality in Acute Cardiovascular Disease</title><author>Martín-Rodríguez, Francisco ; López-Izquierdo, Raúl ; Castro Villamor, Miguel A. ; del Pozo Vegas, Carlos ; Delgado Benito, María del Pilar ; Martínez Caballero, Carmen M. ; Priego Martínez, Vicente ; Martín Conty, José Luis ; Mayo-Iscar, Agustín ; Sánchez-Soberón, Irene ; Baez, Gemma Pastor</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4016-7f75f4069f5bd011dc54eaef84056ffbc9b902bfaa291447c7e46846d352d1503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acute Disease - mortality</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiovascular Diseases - blood</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Cardiovascular Diseases - pathology</topic><topic>Emergency Medical Services</topic><topic>Female</topic><topic>Humans</topic><topic>Lactic Acid - blood</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multicenter Studies as Topic</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>ROC Curve</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martín-Rodríguez, Francisco</creatorcontrib><creatorcontrib>López-Izquierdo, Raúl</creatorcontrib><creatorcontrib>Castro Villamor, Miguel A.</creatorcontrib><creatorcontrib>del Pozo Vegas, Carlos</creatorcontrib><creatorcontrib>Delgado Benito, María del Pilar</creatorcontrib><creatorcontrib>Martínez Caballero, Carmen M.</creatorcontrib><creatorcontrib>Priego Martínez, Vicente</creatorcontrib><creatorcontrib>Martín Conty, José Luis</creatorcontrib><creatorcontrib>Mayo-Iscar, Agustín</creatorcontrib><creatorcontrib>Sánchez-Soberón, Irene</creatorcontrib><creatorcontrib>Baez, Gemma Pastor</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Shock (Augusta, Ga.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martín-Rodríguez, Francisco</au><au>López-Izquierdo, Raúl</au><au>Castro Villamor, Miguel A.</au><au>del Pozo Vegas, Carlos</au><au>Delgado Benito, María del Pilar</au><au>Martínez Caballero, Carmen M.</au><au>Priego Martínez, Vicente</au><au>Martín Conty, José Luis</au><au>Mayo-Iscar, Agustín</au><au>Sánchez-Soberón, Irene</au><au>Baez, Gemma Pastor</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Prognostic Value of Prehospital Blood Lactate Levels to Predict Early Mortality in Acute Cardiovascular Disease</atitle><jtitle>Shock (Augusta, Ga.)</jtitle><addtitle>Shock</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>53</volume><issue>2</issue><spage>164</spage><epage>170</epage><pages>164-170</pages><issn>1073-2322</issn><eissn>1540-0514</eissn><abstract>INTRODUCTION:The knowledge of the prognostic value of prehospital lactate (PLA) is limited. Our objective was to evaluate the predictive capacity of PLA to predict early mortality (within 48 h) from the index event in acute cardiovascular disease (ACVD).
METHODS:Prospective, longitudinal, multicenter, observational study in patients, attended by advanced life support units, transferred to the emergency department of their reference hospital and diagnosed with ACVD. We collected demographic, physiological, clinical, analytical variables, main cardiological diagnosis, and data on hospital admission and early mortality. The main outcome variable was mortality from any cause within 2 days.
RESULTS:Between March 1, 2018 and January 31, 2019, a total of 492 patients were included in our study. Early mortality after the index event within the first 48 h affected 27 patients (5.5%). The most frequent cause of care demand was chest pain with 223 cases (45.3%). The predictive power of PLA to discriminate mortality at 2 days obtained an area under the curve of 0.911 (95% confidence interval [CI]0.83–0.98, P < 0.001). A value equal or superior to 4.3 mmol/L globally attained a sensitivity of 92.6% (95% CI, 76.6–97.9) with a specificity of 82.8% (95% CI, 79.1–86.0), with a positive predictive value of 23.8 (16.7–32.8) and a negative predictive value of 99.5 (98.1–99.9).
CONCLUSION:PLA represents a prognostic biomarker with excellent predictive capacity for ACVD. Prehospital Emergency Services (PhEMS) should incorporate this test routinely in their usual procedures.</abstract><cop>United States</cop><pub>by the Shock Society</pub><pmid>30998648</pmid><doi>10.1097/SHK.0000000000001356</doi><tpages>7</tpages></addata></record> |
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| ispartof | Shock (Augusta, Ga.), 2020-02, Vol.53 (2), p.164-170 |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; EZB-FREE-00999 freely available EZB journals |
| subjects | Acute Disease - mortality Aged Aged, 80 and over Cardiovascular Diseases - blood Cardiovascular Diseases - mortality Cardiovascular Diseases - pathology Emergency Medical Services Female Humans Lactic Acid - blood Male Middle Aged Multicenter Studies as Topic Predictive Value of Tests Prognosis Prospective Studies ROC Curve |
| title | The Prognostic Value of Prehospital Blood Lactate Levels to Predict Early Mortality in Acute Cardiovascular Disease |
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