Correlation Between Blood Lactate Level and Hospitalization and Prognosis in Drug Intoxication Patients in Emergency Medicine Department

A. Turk, A. Kalkan, Ş. Atiş, M. Topal, B. Çekmen, Ö. Bozan, H. Topacoglu
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Abstract

Background: Several drug intoxications can affect both pulmonary and cellular respiration. We therefore think that assessing blood lactate levels can provide information about prognosis. Blood lactate levels have provided information about prognosis in several diseases involving hypoxia at the cellular level, such as sepsis and trauma. The purpose of this study was to determine whether there is any relation between blood lactate levels and mortality, morbidity, and prognosis in patients presenting to the emergency department with drug intoxication. Methods: This retrospective cross-sectional study involved patients admitted to the emergency department due to suicidal drug intoxication over a one-year period (January to December 2016). The primary outcome measure was the relationship between serum lactate concentrations and patient discharge or hospitalization, and if hospitalized, the duration of stay. The secondary outcome measure was the relationship between serum lactate concentrations and toxic dose intake in single-drug intoxication. Results: We enrolled 372 patients, of whom 192 were analyzed after exclusion criteria application. The mean blood lactate level in the total patient group was 2.6±1.46, and 2.7±1.9 in the single drug group and 2.5±1.3 in the multidrug group. Also, blood lactate levels in the overdose group and toxic dose group were 3.4±3.0 and 2.4±0.9, respectively. No significant differences were determined in the lactate level, discharge, hospitalization and the length of hospital stay between the single drug and multidrug groups. In the toxic dose group, patient ages and number of admissions to intensive care unit were significantly higher than in the overdose group. The number of discharges was significantly lower in the toxic dose group. No correlation was determined between the serum lactate level and the length of hospital stay. Conclusion: Lactate level is not a useful parameter for predicting hospitalization in drug intoxication patients.
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急诊科药物中毒患者血乳酸水平与住院及预后的相关性
背景:几种药物中毒会影响肺部和细胞呼吸。因此,我们认为评估血液乳酸水平可以提供有关预后的信息。血液乳酸水平已经提供了一些涉及细胞水平缺氧的疾病的预后信息,如败血症和创伤。本研究的目的是确定血液乳酸水平与药物中毒急诊患者的死亡率、发病率和预后之间是否存在任何关系。方法:这项回顾性横断面研究涉及一年内(2016年1月至12月)因自杀性药物中毒而住进急诊室的患者。主要的结果指标是血清乳酸浓度与患者出院或住院之间的关系,以及如果住院,住院时间。次要的结果指标是单药中毒时血清乳酸浓度与毒性剂量摄入之间的关系。结果:我们招募了372名患者,其中192人在应用排除标准后进行了分析。总患者组的平均血乳酸水平为2.6±1.46,单药组为2.7±1.9,多药组为2.5±1.3。此外,用药过量组和中毒剂量组的血乳酸水平分别为3.4±3.0和2.4±0.9。单药组和多药组在乳酸水平、出院、住院和住院时间方面没有显著差异。在中毒剂量组中,患者年龄和进入重症监护室的次数明显高于服药过量组。毒性剂量组的出院次数明显较低。血清乳酸水平与住院时间之间没有相关性。结论:乳酸水平不是预测药物中毒患者住院的有用参数。
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12 weeks
期刊介绍: Asia Pacific Journal of Medical Toxicology (APJMT) aims to expand the knowledge of medical toxicology and tries to provide reliable information in this field for medical and healthcare professionals. APJMT mainly focuses on research related to medical toxicology issues in the Asia Pacific region and publishes articles on clinical and epidemiological aspects of toxicology, poisonings emergency care, addiction, drug interactions and adverse effects. The journal accepts and welcomes high quality papers in the form of original articles and rarely review articles, case reports and scientific letters relevant to medical practice in toxicology.
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