title: [Serum lactate in the emergency department as a prognostic factor in patients with sepsis without hypotension].
abstract: OBJECTIVE
  The relationship between lactate and mortality in patients without hypotension has not been appropriately explored. Our aim was to determine the usefulness of serum lactate as a prognostic factor of 28-day mortality in patients admitted to the Emergency Department with clinical diagnosis of sepsis without septic shock.
  
  
  METHODS
  We performed a secondary analysis of the study The epidemiology of sepsis in Colombia, a prospective cohort of patients from 10 general hospitals in 4 Colombian cities. We analyzed patients without hypotension with serum lactate available and admitted with community-acquired infections, which were confirmed according to the Centers for Disease Control and Prevention CDC criteria. A logistical regression was performed adjusting for age, sex, comorbidities and severity scores.
  
  
  RESULTS
  We included 961 patients aged 57.2 ± 21.0 years, 54.2% were females, mean SOFA score was 3.0 ± 2.3 and APACHE score was 11.1±6.4. We observed a linear relationship between serum lactate and the odds of death, and after adjustment there was a significant and independent association between lactate and mortality (odds ratio 1,16, 95% confidence interval 1.02-1.33).
  
  
  CONCLUSIONS
  Serum lactate is independently and significantly associated with 28-day mortality among patients with infection who present to the Emergency Department without hypotension. Besides, mortality increases in a linear way with serum lactate from any detectable value.
authors.affiliation: Departamento de Medicina Interna, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Londoño
authors.forename: Alba Luz
authors.initials: AL
authors.lastname: León
authors.forename: Ferney
authors.initials: F
authors.lastname: Rodríguez
authors.forename: Lena
authors.initials: L
authors.lastname: Barrera
authors.forename: Gisela
authors.initials: G
authors.lastname: de la Rosa
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Dennis
authors.forename: Carmelo
authors.initials: C
authors.lastname: Dueñas
authors.forename: Marcela
authors.initials: M
authors.lastname: Granados
authors.forename: Dario
authors.initials: D
authors.lastname: Londoño
authors.forename: Francisco
authors.initials: F
authors.lastname: Molina
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ortiz
authors.forename: Fabián
authors.initials: F
authors.lastname: Jaimes
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D001794:Blood Pressure; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000097:blood*; D015897:Comorbidity; D004636:Emergency Service, Hospital; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007773:Lactates / Q000097:blood*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018805:Sepsis / Q000097:blood*; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007773:Lactates