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

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• 作者：Dong Young Seo ; MD^a ; Sion Jo ; MD^a ; ^{akynei@naver.com" class="auth_mail" title="E-mail the corresponding author} ; Jae Baek Lee ; MD ; PhD^a ; Young Ho Jin ; MD ; PhD^a ; Taeoh Jeong ; MD ; PhD^a ; Jaechol Yoon ; MD^a ; Boyoung Park ; MD^b
• 刊名：The American Journal of Emergency Medicine
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：34
• 期：8
• 页码：1359-1363
• 全文大小：350 K

文摘

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.