<> "The repository administrator has not yet configured an RDF license."^^ . <> . . . "Novel prehospital lactate cut-off estimation for mortality: a multicentre observational study"^^ . "Objectives: Point-of-care testing available in prehospital settings requires the establishment of new medical decision points. The aim of the present work was to determine the cut-off of the lactate threshold that activates alert triggers for all-cause 2-day mortality.\n\nDesign: Multicentre, prospective, ambulance-based, observational study.\n\nSetting: Patients treated via emergency medical services (EMSs) and delivered to the emergency department between 2019 and 2023 were selected in Spain.\n\nParticipants: Adults with any acute disease.\n\nPrimary and secondary outcome measures: Epidemiological data, vital signs and prehospital point-of-care glucose and lactate levels were obtained. The outcome was all-cause 2-day in-hospital mortality. The cut-offs were obtained via three different methods: (i) indirect (which considers survivors and non-survivors), direct (which considers only survivors) assessment and lactate quartile. Additionally, the quartile approach was used to determine the differences in lactate distribution between survivors and non-survivors. Three different back-to-back studies with the same methodology were used.\n\nResults: A total of 11 713 patients fulfilled the inclusion criteria. The mortality rate was 4.6% (542 patients). The difference in the median prehospital lactate concentration (mmol/L) between survivors and non-survivors was statistically significant (p<0.001): 2.29 (95% CI 1.43 to 3.38) and 7.14 (95% CI 5.11 to 9.71), respectively. Globally, the cut-off for all the studies combined was estimated by the direct method to be 3.71 mmol/L (95% CI 2.92 to 3.91), which was similar to the indirect value of 3.07 (95% CI 2.95 to 5.49) and the third quartile of 4.00. The mortality rate in patients who were less than 3.71 mmol/L was 0.004%, and that above that cut-off was 18%.\n\nConclusions: This study established a real-world lactate cut-off for 2-day in-hospital mortality of 3.71 mmol/L (95% CI 2.92 to 3.91) on the basis of data from the EMS. Considering this cut-off point could improve patient management via EMS services, allowing quick identification of patients at high risk of clinical worsening."^^ . "2024-12" . . . "14" . "12" . . "BMJ Open"^^ . . . "20446055" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "Pedro Ángel"^^ . "de Santos Castro"^^ . "Pedro Ángel de Santos Castro"^^ . . "Luis Alonso"^^ . "Dzul López"^^ . "Luis Alonso Dzul López"^^ . . "Silvia"^^ . "Aparicio Obregón"^^ . "Silvia Aparicio Obregón"^^ . . "Ancor"^^ . "Sanz-Garcia"^^ . "Ancor Sanz-Garcia"^^ . . "Carlos"^^ . "del Pozo Vegas"^^ . "Carlos del Pozo Vegas"^^ . . "Eduardo René"^^ . "Silva Alvarado"^^ . "Eduardo René Silva Alvarado"^^ . . "Daniel"^^ . "Zalama-Sánchez"^^ . "Daniel Zalama-Sánchez"^^ . . "Rubén"^^ . "Calderón Iglesias"^^ . "Rubén Calderón Iglesias"^^ . . "Raúl"^^ . "López-Izquierdo"^^ . "Raúl López-Izquierdo"^^ . . "Santos"^^ . "Gracia Villar"^^ . "Santos Gracia Villar"^^ . . "Francisco"^^ . "Martín-Rodríguez"^^ . "Francisco Martín-Rodríguez"^^ . . . . . . "Novel prehospital lactate cut-off estimation for mortality: a multicentre observational study (Texto)"^^ . . . "e091789.full.pdf"^^ . . . "Novel prehospital lactate cut-off estimation for mortality: a multicentre observational study (Otro)"^^ . . . . . . "indexcodes.txt"^^ . . "HTML Summary of #15984 \n\nNovel prehospital lactate cut-off estimation for mortality: a multicentre observational study\n\n" . "text/html" . . . "Biomedicine"@en . "Biomedicina"@es . .