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Plasma lactate at admission does not predict mortality and complications in hip fracture patients : a prospective observational study
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- Jonsson, Magnus H. (författare)
- Lund University,Lunds universitet,Cirkulationsfysiologi vid kritisk sjukdom,Forskargrupper vid Lunds universitet,Fluid resuscitation in critical illness,Lund University Research Groups,Department of Anaesthesia and Intensive Care Medicine, Ystad Hospital, Ystad, Sweden;;Department of Clinical Sciences, Lund University, Lund, Sweden;
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- Hommel, Ami (författare)
- Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Department of Clinical Sciences, Lund University, Lund, Sweden;;Department of Orthopaedics, Skåne University Hospital, Lund, Sweden;
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- Turkiewicz, Aleksandra (författare)
- Lund University,Lunds universitet,Lund OsteoArthritis Division - Clinical Epidemiology Unit,Forskargrupper vid Lunds universitet,Lund University Research Groups,Department of Clinical Sciences, Lund University, Lund, Sweden;;Clinical Epidemiology Unit Orthopaedics, Skåne University Hospital, Lund, Sweden;
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- (creator_code:org_t)
- 2018-10-01
- 2018
- Engelska.
- Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa UK Limited. - 0036-5513 .- 1502-7686. ; 78:6, s. 508-514
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- Hip fractures in elderly carry a high mortality. Our objective was to test the hypothesis that plasma lactate concentration at hospital admission can be used to identify patients with a high risk for poor outcome. Hip fracture patients admitted to a university hospital in Sweden from January 2011 to August 2014 in whom a venous lactate was obtained at admission were included in this prospective observational study. Primary outcome measure was 30-d mortality and secondary outcome measure was a composite outcome of 30-d mortality and postoperative complications. Lactate concentration was evaluated as a continuous predictor using logistic regression, crude and adjusted for age, gender and American Society of Anesthesiology Physical Status (ASA PS) score. Discrimination was evaluated using receiver operating characteristics (ROC) analysis. Totally, 690 patients were included. Median age was 84 years (interquartile range [IQR] 77–90). At 30-d follow-up, mortality was 7.2%, and 45% of the patients had suffered the composite outcome. Median lactate level was 1.3 mmol/L (IQR 1.0–1.8 mmol/L). The odds ratio (OR) by each 1.0 mmol/L increase in the lactate concentration for 30-d mortality was 1.13 (95% CI 0.77–1.68) while for the composite outcome it was 1.06 (95% CI 0.85–1.3). Similar results were obtained after adjustment for age, sex and ASA PS classification for both outcomes. Area under the ROC curve for lactate as a predictor of 30-d mortality was 0.51 (95% CI 0.45–0.57). In our cohort, plasma lactate at admission does not appear to be a useful biomarker to identify high-risk patients after hip fracture.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
Nyckelord
- emergency department
- Hip fracture
- lactate
- mortality
- orthopaedics
- postoperative complications
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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- Scandinavian Journal of Clinical and Laboratory Investigation (Sök värdpublikationen i LIBRIS)
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