Your browser has javascript turned off or blocked. This will lead to some parts of our website to not work properly or at all. Turn on javascript for best performance.

The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here: https://www.microsoft.com/en-us/microsoft-365/windows/end-of-ie-support).

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

Default user image.

Olle Melander

Principal investigator

Default user image.

Plasma lactate at admission does not predict mortality and complications in hip fracture patients : a prospective observational study

Author

  • Magnus H. Jonsson
  • Ami Hommel
  • Aleksandra Turkiewicz
  • Ulf Ekelund
  • Olle Melander
  • Martin Englund
  • Peter Bentzer

Summary, in English

Hip fractures in elderly carry a high mortality. Our objective was to test the hypothesis that plasma lactate concentration at hospital admission can be used to identify patients with a high risk for poor outcome. Hip fracture patients admitted to a university hospital in Sweden from January 2011 to August 2014 in whom a venous lactate was obtained at admission were included in this prospective observational study. Primary outcome measure was 30-d mortality and secondary outcome measure was a composite outcome of 30-d mortality and postoperative complications. Lactate concentration was evaluated as a continuous predictor using logistic regression, crude and adjusted for age, gender and American Society of Anesthesiology Physical Status (ASA PS) score. Discrimination was evaluated using receiver operating characteristics (ROC) analysis. Totally, 690 patients were included. Median age was 84 years (interquartile range [IQR] 77–90). At 30-d follow-up, mortality was 7.2%, and 45% of the patients had suffered the composite outcome. Median lactate level was 1.3 mmol/L (IQR 1.0–1.8 mmol/L). The odds ratio (OR) by each 1.0 mmol/L increase in the lactate concentration for 30-d mortality was 1.13 (95% CI 0.77–1.68) while for the composite outcome it was 1.06 (95% CI 0.85–1.3). Similar results were obtained after adjustment for age, sex and ASA PS classification for both outcomes. Area under the ROC curve for lactate as a predictor of 30-d mortality was 0.51 (95% CI 0.45–0.57). In our cohort, plasma lactate at admission does not appear to be a useful biomarker to identify high-risk patients after hip fracture.

Department/s

  • Fluid resuscitation in critical illness
  • Orthopaedics (Lund)
  • Lund OsteoArthritis Division - Clinical Epidemiology Unit
  • Experimental Vascular Research
  • Cardiovascular Research - Hypertension
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence in Diabetes Research in Sweden

Publishing year

2018-10-01

Language

English

Pages

508-514

Publication/Series

Scandinavian Journal of Clinical and Laboratory Investigation

Volume

78

Issue

6

Document type

Journal article

Publisher

Informa Healthcare

Topic

  • Orthopedics

Keywords

  • emergency department
  • Hip fracture
  • lactate
  • mortality
  • orthopaedics
  • postoperative complications

Status

Published

Research group

  • Fluid resuscitation in critical illness
  • Lund OsteoArthritis Division - Clinical Epidemiology Unit
  • Experimental Vascular Research
  • Cardiovascular Research - Hypertension

ISBN/ISSN/Other

  • ISSN: 0036-5513