Acil Serviste Pulmoner Emboli Tanısı Alan Hastalarda Laktat ve Laktat Klerensinin Mortalite Üzerine Etkisinin Retrospektif Değerlendirilmesi

Abstract

Aim: Pulmonary embolism (PE) is the third leading cause of death due to cardiovascular disease. The presence of shock or hypotension remains the main prognostic clinical marker and to date, it is the only factor that indicates the need for aggressive treatment. Most patients with pulmonary embolism are normotensive. Prognostic indicators are needed to better classify patients with pulmonary embolism. This study aimed to investigate the effect of lactate level on predicting hospital mortality in patients diagnosed with pulmonary embolism in the emergency department, and the effect of lactate clearance on mortality in patients with high lactate levels (lactate ≥2 mmol/L). Material and Methods: This study was designed as a retrospective study. Adult patients (>18-years old) who were diagnosed with PE by computed tomography angiography of the thorax in the university hospital emergency between January 1, 2018, and December 31, 2019, were analyzed. Results: A total of 367 patients were diagnosed with pulmonary embolism in the emergency department. In-hospital mortality rate of the patients was 29.8% and the pulmonary embolism-related mortality rate was 12.4%. Lactate clearance was not significant in predicting mortality risk. In the logistic regression analysis performed among the risk factors affecting mortality in patients with pulmonary embolism, lactate ≥3 mmol/L and normotensive + lactate ≥3 mmol/L were significant in predicting in-hospital mortality. Conclusion: The lactate level in the emergency department could be an effective screening method for identifying mortality in acute pulmonary embolism patients.