Effect of initial lactate level on short-term survival in patients with out-of-hospital cardiac arrest

摘要

Purpose This study evaluated whether serum lactate levels (SLL) at admission in patients with cardiac arrest (CA) can predict successful return of spontaneous circulation (ROSC) or short-term survival, especially within the first 24?h. Materials and methods This prospective, observational study was conducted in the emergency department (ED) of a training and research hospital from April 2015 through February 2016. It included all patients older than 18 years who presented to the ED during the study period with non-traumatic out-of-hospital cardiac arrest (OHCA). The study measured two outcomes: whether ROSC was achieved and whether short-term survival was achieved. ROSC was defined as the presence of spontaneous circulation for the first hour after cardiopulmonary resuscitation (CPR). Survival was defined as having survived for a minimum of 24?h after ROSC. Results The study included 140 patients who were admitted to the ED with OHCA. ROSC was achieved in 55 patients (39.3%), and survival for 24?h following CA was achieved in 42 patients (30%). The mean SLL in the ROSC (+) and ROSC (-) groups were 9.1?±?3.2?mmol/L and 9.8?±?2.9?mmol/L, respectively. The mean SLL in the survivor and non-survivor groups were 8.6?±?2.9?mmol/L and 10?±?3.1?mmol/L, respectively. These differences were not statistically significant (p?=?0.1). A multivariate regression model assessing the factors that predicted both ROSC and 24-h survival showed the odds ratio (OR) of initial SLL was 1.3 (95% CI: 1.05–1.6) and 1.1 (95% CI: 0.9–1.3), respectively. Conclusions This study showed that in OHCA patients, SLL on admission was not associated with increased ROSC achievement or 24-h survival.