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在急诊室的严重高乳糖血症:临床特征,病因和死亡率

Thanat Tangpaisarn¹, Byron C Drumheller², Ronnakorn Daungjunchot¹

¹Department of Emergency Medicine, Faculty of Medicine, Thanon Mittraphap, KhonKaen University, Amphoe Mueang, Khon Kaen, 40002, Thailand.

BMC emergency medicine

|August 20, 2024

概括

在急诊室的严重超乳糖血症显著增加死亡率和ICU入院率. 然而,结果因潜在原因而异,诸如创伤和休克等条件构成最高风险.

科学领域:

紧急医疗紧急医疗
关键的护理关键的护理
临床生物化学临床生物化学

背景情况:

严重的高乳糖血症 (乳酸盐≥10 mmol/L) 与重症患者的高死亡率有关.
有限的数据存在于严重的高乳糖血症,特别是在急诊室 (ED) 的人群中.
这项研究调查了ED患者的特征,原因和结果,这些患者患有严重的高乳糖血症.

研究的目的:

为了确定在ED环境中严重的高乳糖血症的患病率.
分析临床特征,病因和相关死亡率.
根据严重高乳糖血症的潜在原因来分层死亡风险.

主要方法:

在第三级护理医院进行的回顾性队列研究.
包括成年患者,在ED测量了静脉乳酸水平.
排除了特定的患者群体 (例如,医院外心脏骤停) 和缺少数据的患者.

主要成果:

在分析的ED患者中,1.7%患有严重的乳糖高血症 (乳酸盐≥10mmol/L).
严重的高乳糖血症与显著更高的死亡率 (29%在7天,38%在60天) 和ICU入院率有关.
死亡风险因病因而异:高风险 (非败血性休克,创伤/烧伤,神经问题) 的死亡率>50%,中等风险 (没有休克的感染) 的死亡率为36%,低风险 (发作,昏) 的死亡率为0%.

结论:

在ED中,严重的高乳糖血是增加死亡率和ICU利用率的重要预测因素.
病因学在确定患者结果方面发挥着至关重要的作用,在不同的初级诊断中死亡率各不相同.
基于潜在疾病的风险分层对于治疗患有严重高乳糖血症的ED患者至关重要.

关键词:

应急部门的紧急情况.乳酸盐是一种乳酸盐.严重的高乳糖血症.

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