Delay of Lactate Draws in Sepsis Ups Risk of In-Hospital Death
The highest in-hospital mortality was seen in patients with delayed lactate measurements, which increased time to antibiotic administration.
HealthDay News — Each hour of delay in detecting abnormal lactates in patients with sepsis increases the odds of in-hospital death, according to a study published online May 24 in CHEST.
Xuan Han, M.D., from the University of Chicago, and colleagues evaluated the implications of the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) on patient care and outcomes among adults admitted to a single institution between November 2008 and January 2016.
The researchers found that lactates were measured within the mandated window 32 percent of the time on the ward (505 patients) compared with the intensive care unit (55 percent; 818 patients) and the emergency department (79 percent; 2,144 patients).
The highest in-hospital mortality (29 percent) was seen in patients with delayed lactate measurements, which increased time to antibiotic administration. Increased odds of death were seen in patients with initial lactates >2.0 mmol/L and hourly delay in lactate measurement (odds ratio, 1.02).
"Systematic early lactate measurement for all patients with sepsis will lead to a significant increase in lactate draws that may prompt more rapid physician intervention for patients with abnormal initial values," the authors write.