Assessment of Serial Lactate Levels as Predictors of Outcome in Hemodynamically Unstable Patients Presenting to the Emergency Department
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Abstract
Background: Hemodynamic instability is a life-threatening condition frequently encountered in emergency departments, requiring rapid assessment and management. Blood lactate level has emerged as a key biomarker for evaluating tissue hypoxia and predicting patient outcomes. Objective: To evaluate whether initial and serial blood lactate levels after presentation to the emergency department are helpful in predicting outcomes in patients presenting with hemodynamic instability. Material and Methods: This prospective observational study included 50 patients presenting with hemodynamic instability to the emergency department of a tertiary care centre over 15 months. Lactate levels were measured at admission and after six hours. Patients were followed for outcomes including in-hospital mortality and duration of hospital stay. Data were analyzed using SPSS version 25, with p-values <0.05 considered statistically significant. Results: Elevated lactate levels (>4 mmol/L) at admission were observed in 34% of patients and were significantly associated with higher mortality (41.2%) compared to lower lactate groups. Persistently elevated lactate levels at six hours were also linked to poorer outcomes. Patients with higher lactate levels showed significantly lower systolic blood pressure, higher heart and respiratory rates, and lower oxygen saturation at admission. Length of hospital stay was significantly longer in patients with elevated lactate levels. Conclusion: Elevated admission and persistent lactate are significantly associated with increased mortality and prolonged hospital stay in hemodynamically unstable patients. Serial lactate monitoring serves as a valuable prognostic tool to guide early intervention and improve outcomes in emergency settings.
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Copyright (c) 2025 Dr Nikul K Patel, Dr Jay C Patel, Dr. Chaitri T Shah, Dr Surbhibahen J Vadi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
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