Elevated Lactate Is Associated with Mortality in Trauma Patients

To evaluate the associations between lactate, lactate clearance, and mortality, researchers prospectively evaluated 586 trauma patients (82% with blunt trauma) admitted to a level 1 trauma center in France. Lactate levels were measured upon arrival and 2 or 4 hours later.

The overall mortality rate was 13%. Median prehospital time (65 minutes) did not correlate with initial lactate level. Among patients with elevated initial lactate levels (>2.2 mM/L), the mean initial lactate level was 5.0 mM/L, and lactate clearance was 7% per hour during the first two hours and 10% per hour during the first 4 hours. Initial lactate levels correlated with mortality significantly better than lactate clearance did (area under the receiver-operating character…