Lactate on emergency department arrival as a predictor of mortality and site-of-care in pneumonia patients: a cohort study

Abstract

Lactate is superior to CURB-65 in predicting mortality, hospitalisation and ICU admission in pneumonia patients in the ED. LAC-CURB-65 significantly improved the predictive value of CURB-65.

Prediction model for mortality in cancer patients with pneumonia: comparison with CURB‐65 and PSI

“…The PSI assigns 30 additional points to patients with neoplastic disease, and therefore cancer patients are given higher points. Chen et al 24 studied patients with unselected pneumonia, CAP or HCAP, and found that elevated lactate levels on ED arrival was associated with increased mortality in these cases. In our current study series, most patients (81%) were categorized as high risk using the PSI.…”

“…In addition, Shapiro et al 22 demonstrated that a single measurement of venous lactate provides risk-stratification information about inhospital mortality within 3 days. Chen et al 24 studied patients with unselected pneumonia, CAP or HCAP, and found that elevated lactate levels on ED arrival was associated with increased mortality in these cases. They also showed that lactate levels alone performed better in predicting mortality than CURB-65.…”

Community-Acquired Pneumonia

“…A prospective observational study comparing CURB-65 and serum lactate in 1641 patient with CAP showed that lactate better predicted 28-day mortality, hospitalization, and ICU admission. 33 Lactate should routinely be drawn along with blood cultures as part of the workup for patients being hospitalized with severe CAP to help guide resuscitation, treatment, and disposition.…”

How and when to use common biomarkers in community-acquired pneumonia

“…A more familiar metabolomic example, which has been used in critical care for prognosis and severity, is lactate. In adults with pneumonia, the lactate level has been shown to be a better predictor of 28-day mortality than the CURB-65 score, and a combination of CURB-65 with lactate level improves the predictive value of CURB-65 score alone [35]. For further reading Nickler and colleagues have written an interesting review article looking at this growing field and its impact on our understanding of respiratory conditions [32].…”