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Observational Study
. 2023 May 23;24(11):9121.
doi: 10.3390/ijms24119121.

Comparison between Capillary and Serum Lactate Levels in Predicting Short-Term Mortality of Septic Patients at the Emergency Department

Matteo Guarino  1 , Benedetta Perna  1 , Alice Eleonora Cesaro  1 , Michele Domenico Spampinato  1 , Rita Previati  2 , Anna Costanzini  1 , Martina Maritati  3 , Carlo Contini  3 , Roberto De Giorgio  1
Affiliations
Observational Study

Comparison between Capillary and Serum Lactate Levels in Predicting Short-Term Mortality of Septic Patients at the Emergency Department

Matteo Guarino et al. Int J Mol Sci. .

Abstract

Sepsis is a time-dependent and life-threating condition related to macro- and micro-circulatory impairment leading to anaerobic metabolism and lactate increase. We assessed the prognostic accuracy of capillary lactates (CLs) vs. serum ones (SLs) on 48-h and 7-day mortality in patients with suspected sepsis. This observational, prospective, single-centre study was conducted between October 2021 and May 2022. Inclusion criteria were: (i) suspect of infection; (ii) qSOFA ≥ 2; (iii) age ≥ 18 years; (iv) signed informed consent. CLs were assessed with LactateProTM2®. 203 patients were included: 19 (9.3%) died within 48 h from admission to the Emergency Department, while 28 (13.8%) within 7 days. Patients deceased within 48 h (vs. survived) had higher CLs (19.3 vs. 5 mmol/L, p < 0.001) and SLs (6.5 vs. 1.1 mmol/L, p = 0.001). The best CLs predictive cut-off for 48-h mortality was 16.8 mmol/L (72.22% sensitivity, 94.02% specificity). Patients within 7 days had higher CLs (11.5 vs. 5 mmol/L, p = 0.020) than SLs (2.75 vs. 1.1 mmol/L, p < 0.001). The multivariate analysis confirmed CLs and SLs as independent predictors of 48-h and 7-day mortality. CLs can be a reliable tool for their inexpensiveness, rapidity and reliability in identifying septic patients at high risk of short-term mortality.

Keywords: capillary lactates; mortality; sepsis; septic shock; serum lactates.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Fagan’s nomograms illustrating the effect of CLs ≥ 16.8 mmol/L and SLs ≥ 2 mmol/L on 48-h mortality.
Figure 2
Figure 2
Fagan’s nomograms illustrating the effect of CLs ≥ 16.8 mmol/L and SLs ≥ 2 mmol/L on 7-day mortality.
See this image and copyright information in PMC

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