Hostname: page-component-848d4c4894-ttngx Total loading time: 0 Render date: 2024-05-13T20:58:04.829Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of Short-Term Mortality Prediction Using Initial Lactate and NEWS+L at Admission in COVID-19 Patients

Published online by Cambridge University Press:  03 January 2023

Özkan Abuzer Open the ORCID record for Özkan Abuzer [Opens in a new window]
Özkan Abuzer*
Affiliation:
Department of Emergency Medicine, University of Health Sciences Umraniye Training and Research Hospital, Istanbul, Turkey
*
Corresponding author: Özkan Abuzer, Email: ebuzerozkan@gmail.com.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To predict the short-term mortality of the serum lactate level and the National Early Warning Score + lactate (NEWS+L) at the time of first admission to the emergency department in COVID-19 patients.

Materials and methods:

This retrospective analysis was performed by screening the data of COVID-19 patients over a 6-month period (from January 15, 2021, to June 15, 2021). The demographic, comorbidities, vital parameters, and lactate values, as well as C- reactive protein (CRP), blood urea nitrogen (BUN), and 28-day mortality data were recorded.

Results:

A total of 70 patients were included in our study. The median (25th - 75th percentile) age was 58 (47.3 - 73.5) years, and 33 (47.1%) patients were female. The mean lactate value was 1.6 (1.2 - 1.98) mmol/L, the mean NEWS was 6 (4-7.75), and the mean NEWS+L was 7.24 ± 2.54. Mortality occurred in 13 (18.2%) of the 70 patients at 28 days. Lactate, NEWS, and NEWS+L had no significant relationship with mortality. None of these parameters was able to predict mortality (P = 0.132, 0.670, and 0.994, respectively).

Conclusion:

Our findings showed that the NEWS+L, NEWS, and lactate level could not predict short-term mortality in COVID-19 patients at the time of first admission.

Keywords

COVID-19lactic acidmortalitySARS-COV-2emergency servicehospital
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e333
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Terpos, E, Ntanasis-Stathopoulos, I, Elalamy, I, et al. Hematological findings and complications of COVID -19. Am J Hematol. 2020;95(7):834-847. doi: 10.1002/ajh.25829 CrossRefGoogle ScholarPubMed
Özdemir, S, Eroglu, S, Algin, A, et al. Analysis of laboratory parameters in patients with COVID-19: experiences from a pandemic hospital. 2021;12. doi: 10.4328/ACAM.20678 CrossRefGoogle Scholar
Hu, H, Yao, N, Qiu, Y. Predictive value of 5 early warning scores for critical COVID-19 patients. Disaster Med Public Health Prep. 2020:1-8. doi: 10.1017/dmp.2020.324 Google ScholarPubMed
Özdemir, S, Akça, HŞ, Algın, A, Altunok, İ, Eroğlu, SE. Effectiveness of the rapid emergency medicine score and the rapid acute physiology score in prognosticating mortality in patients presenting to the emergency department with COVID-19 symptoms. Am J Emerg Med. 2021;49:259-264. doi: 10.1016/j.ajem.2021.06.020 CrossRefGoogle Scholar
Usman, OA, Usman, AA, Ward, MA. Comparison of SIRS, qSOFA, and NEWS for the early identification of sepsis in the Emergency Department. Am J Emerg Med. 2019;37(8):1490-1497. doi: 10.1016/j.ajem.2018.10.058 CrossRefGoogle ScholarPubMed
Spagnolli, W, Rigoni, M, Torri, E, Cozzio, S, Vettorato, E, Nollo, G. Application of the National Early Warning Score (NEWS) as a stratification tool on admission in an Italian acute medical ward: a perspective study. Int J Clin Pract. 2017;71(3-4). doi: 10.1111/ijcp.12934 CrossRefGoogle Scholar
Mitsunaga, T, Hasegawa, I, Uzura, M, et al. Comparison of the National Early Warning Score (NEWS) and the Modified Early Warning Score (MEWS) for predicting admission and in-hospital mortality in elderly patients in the pre-hospital setting and in the emergency department. Peer J. 2019;7:e6947. doi: 10.7717/peerj.6947 CrossRefGoogle ScholarPubMed
Jo, S, Jeong, T, Lee, JB, Jin, Y, Yoon, J, Park, B. Validation of modified early warning score using serum lactate level in community-acquired pneumonia patients. The National Early Warning Score – Lactate score. Am J Emerg Med. 2016;34(3):536-541. doi: 10.1016/j.ajem.2015.12.067 CrossRefGoogle Scholar
Dundar, ZD, Kocak, S, Girisgin, AS. Lactate and NEWS-L are fair predictors of mortality in critically ill geriatric emergency department patients. Am J Emerg Med. 2020;38(2):217-221. doi: 10.1016/j.ajem.2019.02.006 CrossRefGoogle ScholarPubMed
Kim, D, Jo, S, Lee, JB, et al. Comparison of the National Early Warning Score + Lactate score with the pre-endoscopic Rockall, Glasgow-Blatchford, and AIMS65 scores in patients with upper gastrointestinal bleeding. Clin Exp Emerg Med. 2018;5(4):219-229. doi: 10.15441/ceem.17.268 CrossRefGoogle ScholarPubMed
Nolt, B, Tu, F, Wang, X, et al. Lactate and immunosuppression in sepsis. Shock. 2018;49(2):120-125. doi: 10.1097/SHK.0000000000000958 CrossRefGoogle ScholarPubMed
Zhou, H, Lan, T, Guo, S. Stratified and prognostic value of admission lactate and severity scores in patients with community-acquired pneumonia in emergency department. Medicine (Baltimore). 2019;98(41):e17479. doi: 10.1097/MD.0000000000017479 CrossRefGoogle ScholarPubMed
Carpenè, G, Onorato, D, Nocini, R, et al. Blood lactate concentration in COVID-19: a systematic literature review. CCLM. 2022;60(3):332-337. doi: 10.1515/cclm-2021-1115 CrossRefGoogle ScholarPubMed
Velavan, TP, Kieu Linh, LT, Kreidenweiss, A, Gabor, J, Krishna, S, Kremsner, PG. Longitudinal monitoring of lactate in hospitalized and ambulatory COVID-19 Patients. Am J Trop Med Hyg. 2021;104(3):1041-1044. doi: 10.4269/ajtmh.20-1282 Google ScholarPubMed
Benedetti, I, Spinelli, D, Callegari, T, et al. High levels of mid-regional proadrenomedullin in ARDS COVID-19 patients: the experience of a single, Italian Center. Eur Rev Med Pharmacol Sci. 2021;25(3):1743-1751. doi: 10.26355/eurrev_202102_24885 Google Scholar
Wang, D, Hu, B, Hu, C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069. doi: 10.1001/jama.2020.1585 CrossRefGoogle ScholarPubMed
Ospina-Tascón, GA, Hernandez, G, Alvarez, I, et al. Effects of very early start of norepinephrine in patients with septic shock: a propensity score-based analysis. Crit Care. 2020;24(1):52. doi: 10.1186/s13054-020-2756-3 CrossRefGoogle Scholar
Ottestad, W, Seim, M, Mæhlen, JO. COVID-19 with silent hypoxemia. Tidsskrift for Den norske legeforening. Published online April 11, 2020. doi: 10.4045/tidsskr.20.0299 CrossRefGoogle Scholar
Dhont, S, Derom, E, Van Braeckel, E, Depuydt, P, Lambrecht, BN. The pathophysiology of 'happy’ hypoxemia in COVID-19. Respir Res. 2020;21(1):198. doi: 10.1186/s12931-020-01462-5 CrossRefGoogle ScholarPubMed
Smith, GB, Prytherch, DR, Meredith, P, Schmidt, PE, Featherstone, PI. The ability of the National Early Warning Score (NEWS) to discriminate patients at risk of early cardiac arrest, unanticipated intensive care unit admission, and death. Resuscitation. 2013;84(4):465-470. doi: 10.1016/j.resuscitation.2012.12.016 CrossRefGoogle ScholarPubMed
Wellbelove, Z, Walsh, C, Perinpanathan, T, Lillie, P, Barlow, G. Comparing the 4C mortality score for COVID-19 to established scores (CURB65, CRB65, qSOFA, NEWS) for respiratory infection patients. J Infect. 2021;82(3):414-451. doi: 10.1016/j.jinf.2020.10.015 CrossRefGoogle ScholarPubMed