Abstract
Background
Prehospital Emergency Medical Services must attend to patients with complex physiopathological
situations with little data and in the shortest possible time. The objective of this
work was to study lactic acid values and their usefulness in the prehospital setting
to help in clinical decision-making.
Study design
We conducted a longitudinal prospective, observational study on patients over 18 years
of age who, after being evaluated by the Advanced Life Support Unit, were taken to
the hospital between April and June 2018. We analyzed demographic variables, prehospital
lactic acid values and early mortality (<30 days). The area under the curve of the
receiver operating characteristic was calculated for the prehospital value of lactic
acid.
Results
A total of 279 patients were included in our study. The median age was 68 years (interquartile
range: 54–80 years). Overall 30-day mortality was 9% (25 patients). The area under
the curve for lactic acid to predict overall mortality at 30 days of care was 0.82
(95% CI: 0.76–0.89). The lactate value with the best sensitivity and specificity overall
was 4.25 mmol/L with a sensitivity of 84% (95% CI: 65.3–93.6) and specificity of 70%
(95% CI: 65.0–76.1).
Conclusions
The level of lactic acid can be a complementary tool in the field of prehospital emergencies
that will guide us early in the detection of critical patients.
Keywords
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Article Info
Publication History
Published online: November 19, 2018
Accepted:
November 18,
2018
Received in revised form:
October 25,
2018
Received:
August 20,
2018
Footnotes
☆The corresponding author on behalf of the other authors warrants the accuracy, transparency and honesty of the data and information contained in the study, that no relevant information has been omitted and that all discrepancies between authors have been adequately resolved and described.
Identification
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© 2018 Elsevier Inc. All rights reserved.
