Diagnostic performance of initial serum lactate for predicting bacteremia in female patients with acute pyelonephritis

作者：Seo Dong Young; Jo Sion^*; Lee Jae Baek; Jin Young Ho; Jeong Taeoh; Yoon Jaechol; Park Boyoung

来源：American Journal of Emergency Medicine, 2016, 34(8): 1359-1363.

DOI：10.1016/j.ajem.2016.03.062

Objectives: The purpose of the present study was to investigate the diagnostic value of lactate for predicting bacteremia in female patients with acute pyelonephritis (APN).
Methods: We conducted a retrospective study of female patients with APN who visited the study hospital emergency department. The demographics, comorbidities, physiologies, and laboratory variables including white blood cell count and segmented neutrophil count, C-reactive protein, and initial serum lactate levels were collected and analyzed to identify associations with the presence of bacteremia.
Results: During the study period, a total of 314 patients were enrolled. One hundred twenty-three patients (39.2%) had bacteremia. Escherichia coli was the most frequent pathogen. Logistic regression analysis demonstrated that the lactate level was independently associated with the presence of bacteremia (odds ratio, 1.39 [ 95% confidence interval, 1.08-1.78]). The C-statistic of the lactate level was 0.67 (95% CI, 0.60-0.73). At a cutoff value of 1.4 mmol/L, the lactate level predicted bacteremia with a sensitivity (53.7%), specificity (72.3%), positive predictive value (55.5%), negative predictive value (70.8%), positive likelihood ratio (1.93), and negative likelihood ratio (0.64).
Conclusion: The initial serum lactate level showed poor discriminative performance for predicting bacteremia in female patients with APN.

• 出版日期2016-8