title: [Lactate levels as a predictor of mortality in patients with septic shock].
abstract: BACKGROUND
  The objective was to determine the association between serum lactate levels and mortality in patients with septic shock in the Emergency Room of the Instituto Mexicano del Seguro Social's Centro Médico Nacional Adolfo Ruiz Cortines.
  
  
  METHODS
  We included the patients admitted to the Emergency Room with diagnosis of septic shock who had measure of serum lactate at admission during the period 01-12/2013; it was a case-control study. The cut-off value of serum lactate associated with mortality was performed using the ROC (receiver operating characteristic) curves.
  
  
  RESULTS
  Sixty-seven patients were studied, out of which 56 survived (cases) and 11 died (controls). There was no association with gender, age and comorbidities. The cut-off value for mortality of serum lactate was 4.9 mmol/L. Ten patients out of 40 with lactate levels > 4.9 mmol/L, and only one out of 27 with lactate < 4.9 mmol/L died (p = 0.04); odds ratio was of 8.7. The mortality in patients with septic shock and lactate > 4.9 mmol/ is high and had a sensitivity of 90.9 % and specificity of 46.4 %.
  
  
  CONCLUSIONS
  The levels of serum lactate greater than four are associated to an increased risk of mortality in patients with septic shock.
authors.affiliation: Servicio de Urgencias, Hospital de Especialidades 14, Centro Médico Nacional "Lic. Adolfo Ruiz Cortines", Instituto Mexicano del Seguro Social, Veracruz. luis.pereda@imss.gob.mx.
authors.forename: Gualterio
authors.initials: G
authors.lastname: Jasso-Contreras
authors.forename: Felipe
authors.initials: F
authors.lastname: González-Velázquez
authors.forename: Leidiana
authors.initials: L
authors.lastname: Bello-Aguilar
authors.forename: Andrea
authors.initials: A
authors.lastname: García-Carrillo
authors.forename: Mario Ramón
authors.initials: MR
authors.lastname: Muñoz-Rodríguez
authors.forename: Luis
authors.initials: L
authors.lastname: Pereda-Torales
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012772:Shock, Septic / Q000097:blood / Q000175:diagnosis / Q000401:mortality*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019344:Lactic Acid
keywords: Choque séptico; Lactato sérico; Mortalidad