Association of prehospital lactate levels with base excess in various emergencies – a retrospective study
Author:
Eichinger Michael1ORCID, Shah Karan2, Palt Niklas1, Eichlseder Michael1, Pichler Alexander1, Zoidl Philipp1, Zajic Paul1, Rief Martin1
Affiliation:
1. Department of Anaesthesiology and Intensive Care Medicine 1 , 31475 Medical University of Graz , Graz , Austria 2. Section of Biostatistics, Quantitative Health Sciences , 2569 Cleveland Clinic , Cleveland , OH , USA
Abstract
Abstract
Objectives
Blood gas analysis, including parameters like lactate and base excess (BE), is crucial in emergency medicine but less commonly utilized prehospital. This study aims to elucidate the relationship between lactate and BE in various emergencies in a prehospital setting and their prognostic implications.
Methods
We conducted a retrospective analysis of prehospital emergency patients in Graz, Austria, from October 2015 to November 2020. Our primary aim was to assess the association between BE and lactate. This was assessed using Spearman’s rank correlation and fitting a multiple linear regression model with lactate as the outcome, BE as the primary covariate of interest and age, sex, and medical emergency type as confounders.
Results
In our analysis population (n=312), lactate and BE levels were inversely correlated (Spearman’s ρ, −0.75; p<0.001). From the adjusted multiple linear regression model (n=302), we estimated that a 1 mEq/L increase in BE levels was associated with an average change of −0.35 (95 % CI: −0.39, −0.30; p<0.001) mmol/L in lactate levels. Lactate levels were moderately useful for predicting mortality with notable variations across different emergency types.
Conclusions
Our study highlights a significant inverse association between lactate levels and BE in the prehospital setting, underscoring their importance in early assessment and prognosis in emergency care. Additionally, the findings from our secondary aims emphasize the value of lactate in diagnosing acid–base disorders and predicting patient outcomes. Recognizing the nuances in lactate physiology is essential for effective prehospital care in various emergency scenarios.
Publisher
Walter de Gruyter GmbH
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