Open AccessCan capillary lactate improve early warning scores in emergency department? An observational, prospective, multicentre study
Author(s) -
LópezIzquierdo Raúl,
MartínRodríguez Francisco,
Santos Pastor Julio C.,
García Criado Jorge,
Fadrique Millán Laura N.,
Carbajosa Rodríguez Virginia,
Del Brío Ibáñez Pablo,
Del Pozo Vegas Carlos
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.13779
Subject(s) - medicine , early warning score , triage , emergency department , observational study , prospective cohort study , sepsis , emergency medicine , psychiatry
Aims To determine the prognostic usefulness of the National Early Warning Score‐2 (NEWS2) and quick Sepsis‐related Organ Failure Assessment (qSOFA) scores, in isolation and combined with capillary lactate (CL), using the new NEWS2‐L and qSOFA‐L scores to predict the 30‐day mortality risk. Methods Prospective, multicentre and observational study in patients across four EDs. We collected sets of vital signs and CL and subsequently calculated NEWS2, qSOFA, NEWS2‐L and qSOFA‐L scores when patients arrived at the ED. The main outcome measure was all‐cause mortality 30 days from the index event. Results A total of 941 patients were included. Thirty‐six patients (3.8%) died within 30 days of the index event. A high CL level has not been linked to a higher mortality. The NEWS2 presented AUROC of 0.72 (95% CI: 0.62‐0.81), qSOFA of 0.66 (95% CI: 0.56‐0.77) ( P < .001 in both cases) and CL 0.55 (95% CI: 0.42‐0.65; P = .229) to predict 30‐day mortality. The addition of CL to the scores analysed does not improve the results of the scores used in isolation. Conclusion NEWS2 and qSOFA scores are a very useful tool for assessing the status of patients who come to the ED in general for all types of patients in triage categories II and III and for detecting the 30‐day mortality risk. CL determined systematically in the ED does not seem to provide information on the prognosis of the patients.