Table_1_Serum Lactate Could Predict Mortality in Patients With Spontaneous Subarachnoid Hemorrhage in the Emergency Department.DOCX

Background: Serum lactate is a useful biomarker for prediction of mortality in critically ill patients. The purpose of this study was to identify if serum lactate could be used as a biomarker for predicting mortality in patients with subarachnoid hemorrhage (SAH) in the emergency department. Methods: This retrospective study enrolled 189 patients. Baseline demographic data and clinical characteristics of patients were obtained from medical record review. Multiple logistic regression analysis was performed to determine predictor variables significantly associated with mortality. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of variables for mortality prediction in SAH. Results: Using multivariate logistic regression analysis, age [OR 1.05; 95% confidence interval (CI) 1.00–1.10; p = 0.037], Hunt and Hess scale score (OR 3.29; 95% CI 1.62–6.70; p = 0.001), serum lactate level (OR 1.33; 95% CI 1.03–1.74; p = 0.032), and serum glucose level (OR 1.01; 95% CI 1.00–1.02; p = 0.049) predicted overall mortality in SAH. The area under the ROC curve (AUC) value for the use of serum lactate level to predict mortality in SAH was 0.815 (95% CI 0.753–0.868) (p < 0.001). Conclusion: Serum lactate may be a useful biomarker for the early prediction of mortality in SAH patients in the emergency department.背景：血清乳酸是重症患者死亡预测的有效生物标志物。本研究旨在探讨血清乳酸能否作为急诊科蛛网膜下腔出血（subarachnoid hemorrhage, SAH）患者死亡预测的生物标志物。 方法：本回顾性研究纳入189例患者，通过病历回顾收集患者的基线人口学资料与临床特征。采用多因素logistic回归分析筛选与死亡显著相关的预测变量，并通过受试者工作特征曲线（Receiver Operating Characteristic, ROC）分析评估各变量对蛛网膜下腔出血患者死亡的预测效能。 结果：经多因素logistic回归分析显示，年龄[比值比（Odds Ratio, OR）1.05；95%置信区间（Confidence Interval, CI）1.00–1.10；p = 0.037]、Hunt与Hess量表评分[比值比（OR）3.29；95%CI 1.62–6.70；p = 0.001]、血清乳酸水平[比值比（OR）1.33；95%CI 1.03–1.74；p = 0.032]及血糖水平[比值比（OR）1.01；95%CI 1.00–1.02；p = 0.049]均可预测蛛网膜下腔出血患者的全因死亡。血清乳酸水平预测蛛网膜下腔出血患者死亡的ROC曲线下面积（Area Under the Curve, AUC）为0.815（95%CI 0.753–0.868）（p < 0.001）。 结论：血清乳酸可作为急诊科蛛网膜下腔出血患者早期死亡预测的可靠生物标志物。