1. Venous lactate improves the prediction of in-hospital adverse outcomes in normotensive pulmonary embolism
- Author
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Burkert Pieske, Karl Stangl, Charlotta F. Pagel, Matthias Ebner, Veli-Pekka Harjola, Carmen Sentler, Stavros Konstantinides, Gerd Hasenfuß, Mareike Lankeit, Markus H. Lerchbaumer, Héctor Bueno, Ministerio de Economía y Competitividad (España), Fundación ProCNIC, German Federal Ministry of Education and Research, HUS Emergency Medicine and Services, University of Helsinki, and Helsinki University Hospital Area
- Subjects
medicine.medical_specialty ,Adverse outcomes ,Venous lactate ,030204 cardiovascular system & hematology ,GUIDELINES ,DIAGNOSIS ,03 medical and health sciences ,THROMBOEMBOLISM ,0302 clinical medicine ,Internal medicine ,MANAGEMENT ,Internal Medicine ,medicine ,Humans ,In patient ,Lactic Acid ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Risk stratification ,RISK ,Venipuncture ,business.industry ,Biomarker ,ARTERIAL ,Prognosis ,medicine.disease ,EUROPEAN-SOCIETY ,Hospitals ,3. Good health ,Peripheral ,Pulmonary embolism ,3121 General medicine, internal medicine and other clinical medicine ,Cardiology ,Biomarker (medicine) ,Pulmonary Embolism ,business ,TASK-FORCE - Abstract
Arterial lactate is an established risk marker in patients with pulmonary embolism (PE). However, its clinical applicability is limited by the need of an arterial puncture. In contrast, venous lactate can easily be measured from blood samples obtained via routine peripheral venepuncture. We investigated the prognostic value of venous lactate with regard to in-hospital adverse outcomes and mortality in 419 consecutive PE patients enrolled in a single-center registry between 09/2008 and 09/2017. An optimised venous lactate cut-off value of 3.3 mmol/l predicted both, in-hospital adverse outcome (OR 11.0 [95% CI 4.6-26.3]) and all-cause mortality (OR 3.8 [95%CI 1.3-11.3]). The established cut-off value for arterial lactate (2.0 mmol/l) and the upper limit of normal for venous lactate (2.3 mmol/l) had lower prognostic value for adverse outcomes (OR 3.6 [95% CI 1.5-8.7] and 5.7 [95% CI 2.4-13.6], respectively) and did not predict mortality. If added to the 2019 European Society of Cardiology (ESC) algorithm, venous lactate
- Published
- 2021