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Prehospital lactate...
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Magnusson, Carl,1976Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
(author)
Prehospital lactate levels in blood as a seizure biomarker : A multi-center observational study.
- Article/chapterEnglish2021
Publisher, publication year, extent ...
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2021-01-08
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Wiley,2021
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electronicrdacarrier
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LIBRIS-ID:oai:DiVA.org:hb-24645
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https://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-24645URI
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https://doi.org/10.1111/epi.16806DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-54876URI
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https://gup.ub.gu.se/publication/302160URI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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OBJECTIVE: The objective of this study was to assess the value of prehospital measurement of lactate level in blood for diagnosis of seizures in cases of transient loss of consciousness.METHODS: Between March 2018 and September 2019, prehospital lactate was measured with a point-of-care device by the emergency medical services in an area serving a population of 900 000. A total of 383 cases of transient loss of consciousness were identified and categorized as tonic-clonic seizure (TCS), other seizure, syncope, or other cause, according to the final diagnosis in the electronic medical records system. Receiver operating characteristic curve analyses were used to identify the optimal lactate cut-off.RESULTS: A total of 383 cases were included (135 TCS, 42 other seizure, 163 syncope, and 43 other causes). The median lactate level in TCS was 7.0 mmol/L, compared to a median of 2.0 mmol/L in all other cases (P < .001). The area under the curve (AUC) of TCS vs nonepileptic causes was 0.87 (95% confidence interval [CI] 0.83-0.91). The optimal cut-off (Youden index, 67.8%) was 4.75 mmol/L, with 79% sensitivity (95% CI 71-85) and 89% specificity (95% CI 85-93) for TCS.SIGNIFICANCE: Prehospital lactate can be a valuable tool for identifying seizures in transient loss of consciousness. For acceptable specificity, a higher cut-off than that previously demonstrated for hospital-based measurements must be used when values obtained close to the time of the event are interpreted.
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Herlitz, Johan,1949-Gothenburg University,Göteborgs universitet,Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Prehospen–Centre for Prehospital Research, University of Borås, Borås, Sweden,PreHospen,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xherjo
(author)
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Höglind, RobertDepartment of Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
(author)
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Wennberg, Pär,1972-Research and Development Centre, Skaraborg Hospital, Skövde, Sweden.(Swepub:hj)wenpar
(author)
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Edelvik Tranberg, Anna,1971Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xedann
(author)
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Axelsson, ChristerGothenburg University,Göteborgs universitet,Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Prehospen–Centre for Prehospital Research, University of Borås, Borås, Sweden; Department of Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden,PreHospen,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:hb)chax
(author)
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Zelano, Johan,1981Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xzeljo
(author)
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Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin
(creator_code:org_t)
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In:Epilepsia: Wiley62:2, s. 408-4150013-95801528-1167
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