• Pariwat Phungoen, Sittichai Khamsai, Verajit Chotmongkol, Ronnakorn Daungjunchot, Kittisak Sawanyawisuth, and Thanat Tangpaisarn.
• Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
• Intern Emerg Med. 2024 Nov 5.

AbstractPatients presenting with seizure at the emergency department (ED) may have morbidity and mortality. Serum lactate has been shown to be a predictor of diagnosis of seizure versus syncope and mortality in patients presenting with seizure at the ED. There is limited data on using serum lactate as a predictor of the intensive care unit (ICU) admission in patients presenting with seizure at the ED. This study aimed to evaluate if serum lactate can be a predictor of the ICU admission in this setting. This was a retrospective cohort study enrolled adult patients aged 18 years or more, diagnosed with seizures or convulsive status epilepticus at the ED, and who had undergone testing for serum venous lactate. Clinical factors predictive of ICU admission were computed using logistic regression analysis. Of the 288 patients who met the study criteria, 45 patients (15.63%) required ICU admission. Two factors were independently associated with the ICU admission: convulsive status epilepticus and serum lactate. Both factors had adjusted odds ratio (95% confidence interval) of 4.793 (2.119, 10.844) and 1.008 (1.001, 1.016), respectively. Serum lactate of over 63 mg/dL had specificity of 80.25% and sensitivity of 35.56% with the area under ROC curve of 63.30% (95% confidence interval of 54.77%, 71.84%). Serum lactate and convulsive status epilepticus were two predictors of ICU admission in patients presenting with seizure at the ED.© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).

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