Diagnostic performance of initial serum lactate for predicting bacteremia in female patients with acute pyelonephriti
- Authors
- Seo, Dong Young; Jo, Sion; Lee, Jae Baek; Jin, Young Ho; Jeong, Taeoh; Yoon, Jaechol; Park, Bo young
- Issue Date
- Aug-2016
- Publisher
- W. B. Saunders Co., Ltd.
- Citation
- American Journal of Emergency Medicine, v.34, no.8, pp.1359 - 1363
- Indexed
- SCIE
SCOPUS
- Journal Title
- American Journal of Emergency Medicine
- Volume
- 34
- Number
- 8
- Start Page
- 1359
- End Page
- 1363
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/154095
- DOI
- 10.1016/j.ajem.2016.03.062
- ISSN
- 0735-6757
- Abstract
- 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.
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