Does Lactate Clearance Predict Short-Term Mortality in Pulmonary Embolism?

Abstract

Plasma lactate level of ≥ 2 mmol/L can predict pulmonary embolism (PE)-associated adverse outcomes but has led to the question of if monitoring lactate concentration can be more reliable than the adequacy of a single measurement. It could be more beneficial to use repeated assessments of lactate concentration to forecast results in this patient group. This study aims to investigate the predictive value of lactate clearance (LC) in short-term mortality in patients diagnosed with PE in the emergency department (ED). A prospective cross-sectional study was conducted in ED of a tertiary care hospital. Patients who were diagnosed with PE over age 18 were enrolled in the study. The risk factors, vital signs, and lactate levels (at arrival and the 2nd hour) at admission were recorded. The Pulmonary Embolism Severity Index (PESI) scores of the patients were calculated. The 24-h, 7-d, and 30-d survival rates of the patients were evaluated. Then, 77 patients were included in the study. PESI score, basal, and 2nd-hour lactate levels were found significant in predicting 30-day mortality (p = 0.002, 0.009, and 0.002, respectively). Receiver operating characteristic (ROC) curve analyses for PESI, basal, and 2nd-hour lactate levels showed an area under curve (AUC) of 0.703 (95% CI: 0.586–0.820), 0.688 (95% CI: 0.552–0.824), and 0.722 (95% CI: 0.586–0.857), respectively. The predictive performances of PESI, basal, and 2nd-hour lactate level were similar. LC was not significant in predicting the 30-day mortality (p = 0.290). LC was not correlated with mortality in patients with PE.