Abstract
Study objective
The aim of the present study was to investigate the prognostic value of the initial
serum lactate level in patients with community-acquired pneumonia (CAP).
Methods
We collected data on hospitalized adult patients with CAP via the study hospital emergency
department between October 2012 and September 2013. Demographics, comorbidities, and
physiologic and laboratory variables including initial C-reactive protein (CRP) and
serum lactate level were extracted from the electronic medical record. The primary
outcome was inpatient mortality. Comparisons between survivors and nonsurvivors were
performed, and multivariable logistic regression analyses were constructed as dependent
variables of both continuous and categorical varieties.
Results
A total of 397 patients were enrolled, and the mortality cases were 46 (11.6%). The
mean lactate level was 1.7 ± 1.4 mmol/L and was significantly higher in the nonsurvivor
group than in the survivor group (2.4 ± 2.2 mmol/L vs 1.6 ± 1.2 mmol/L). In the multivariable
logistic regression model for inpatient mortality constructed using lactate, CRP,
and laboratory variables of pneumonia severity index (PSI), lactate and CRP remained
as significant factors, but laboratory variables of PSI were not. In other multivariable
logistic regression models for the outcome constructed using collected laboratory
variables and PSI, lactate remained as a significant factor (adjusted odds ratio,
1.24; 95% confidence interval, 1.01-1.53; P = .042 by continuous variable; adjusted odds ratio of third tertile, 2.60; 95% confidence
interval, 1.02-6.66; P = .046 by category variable). C-reactive protein and albumin were also left as significant
factors.
Conclusions
The initial serum lactate level is independently associated with mortality in hospitalized
patients with CAP. However, laboratory variables of PSI or others were not, except
CRP and albumin.
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Article Info
Publication History
Published online: March 06, 2015
Accepted:
March 3,
2015
Received in revised form:
March 2,
2015
Received:
January 30,
2015
Footnotes
☆Conflict of interests: None.
☆☆Funding and support: None.
★Author contributions: M.H.G. and S.J. designed this study. M.H.G. supervised the overall data collection process, had full access to all of the data in the study, and takes responsibility for the integrity of the data. B.P. conducted the data analysis. M.H.G. and S.J. wrote the initial draft of the article. All authors provided substantial review and feedback on the final version of the article. S.J. takes responsibility for the article as a whole.
★All authors have read and approved the submitted manuscript. This article has neither been submitted nor published elsewhere in whole or in part, except as an abstract (if relevant).
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
