Serum Lactate and Mortality in Emergency Department Patients with Cancer

Lactato Sérico y Mortalidad en Pacientes del servicio de Urgencias con Cáncer

Cancer is the second main cause of death in the United States, and is a healthcare problem that is increasing. The number of deaths caused by cancer is expected to increase exponentially in the next 20 years, and therefore, its role in emergency medicine is expected to increase progressively. The authors of this article aim to determine the role of serum lactate in predicting mortality, especially in Emergency Department patients with cancer.

Maher et al. conducted a continuous, retrospective cohort study of all Emergency Department visits recorded from December 2012 to August 2014 at the Mayo Clinic, a single, tertiary, teaching hospital located in Phoenix, Arizona, United States. All patients who had a serum lactate sample taken in the Emergency Deparment before they were admitted to hospital were eligible to take part in this study. Of the 5.440 patients who had their lactate levels measured, 1.837 were cancer patients and 3.603 were non-cancer patients.

Cumulative mortality (determined by hospital records and an external death tracking system) was recorded at one day, three days, seven days, and 30 days. In the adjusted 30-day analysis, patients with cancer had a greater mortality than patients without cancer at every lactate level.

In summary, cancer patients with elevated Emergency Department lactate levels had an increased risk of mortality at virtually all lactate levels and time intervals the authors measured, although these differences only reached statistical significance in later time intervals (day 7 and day 30).

This article was written by Steven A. Maher, M’hamed Temkit, Matthew R. Buras, Ryan Y. McLemore,  Rebecca K. Butler, Yasmynn Chowdhury, Christopher A. Lipinski and Stephen J. Traub. The article was published in July 2018 by Western Journal of Emergency Medicine (DOI: 10.5811/westjem.2018.6.37295)

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Serum Lactate and Mortality in Emergency Department Patients with Cancer