Article InfoTo view the full text, please login as a subscribed user or purchase a subscription. Click here to view the full text on ScienceDirect.
Fig. 1
Flow of the study.
Fig. 2
Comparison of area under the receiver operating characteristic curves of lactate and CRP for bacteremia prediction.
Abstract
Objectives
The purpose of the present study was to investigate the diagnostic value of lactate for predicting bacteremia in female patients with acute pyelonephritis (APN)
Methods
We conducted a retrospective study of female patients with APN who visited the study hospital emergency department (ED). The demographics, co-morbidities, physiologies, and laboratory variables including white blood cell (WBC) count and, segmented neutrophil count, C-reactive protein (CRP) and initial serum lactate levels, were collected and analyzed to identify associations with the presence of bacteremia.
Results
During the study period, a total of 314 patients were enrolled. One hundred twenty-three (39.2%) patients had bacteremia. E.coli was most frequent pathogen. Logistic regression analysis demonstrated that the lactate level was independently associated with the presence of bacteremia (odds ratio 1.39 (95% confidence interval, 1.08-1.78)). The Cstatistic of the lactate level was 0.67 (95% CI, 0.60-0.73). At a cut-off value of 1.4mmol/L, the lactate level predicted bacteremia with a sensitivity (53.7%), specificity (72.3%), positive predictive value (55.5%), negative predictive value (70.8%), positive likelihood ratio (1.93), and negative likelihood ratio (0.64).
Conclusion
The initial serum lactate level showed poor discriminative performance for predicting bacteremia in female patients with APN.
To access this article, please choose from the options below
Purchase access to this article
Claim Access
If you are a current subscriber with Society Membership or an Account Number, claim your access now.
Subscribe to this title
Purchase a subscription to gain access to this and all other articles in this journal.
Institutional Access
Visit ScienceDirect to see if you have access via your institution.
Declaration of Interest: The authors report no conflicts of interest. The authors are responsible for the content and writing of the paper.
Funding: None
