• Gualterio Jasso-Contreras, Felipe González-Velázquez, Leidiana Bello-Aguilar, Andrea García-Carrillo, Mario Ramón Muñoz-Rodríguez, and Luis Pereda-Torales.
• Servicio de Urgencias, Hospital de Especialidades 14, Centro Médico Nacional "Lic. Adolfo Ruiz Cortines", Instituto Mexicano del Seguro Social, Veracruz. luis.pereda@imss.gob.mx.
• Rev Med Inst Mex Seguro Soc. 2015 May 1; 53 (3): 316-21.

BackgroundThe objective was to determine the association between serum lactate levels and mortality in patients with septic shock in the Emergency Room of the Instituto Mexicano del Seguro Social's Centro Médico Nacional Adolfo Ruiz Cortines.MethodsWe included the patients admitted to the Emergency Room with diagnosis of septic shock who had measure of serum lactate at admission during the period 01-12/2013; it was a case-control study. The cut-off value of serum lactate associated with mortality was performed using the ROC (receiver operating characteristic) curves.ResultsSixty-seven patients were studied, out of which 56 survived (cases) and 11 died (controls). There was no association with gender, age and comorbidities. The cut-off value for mortality of serum lactate was 4.9 mmol/L. Ten patients out of 40 with lactate levels > 4.9 mmol/L, and only one out of 27 with lactate < 4.9 mmol/L died (p = 0.04); odds ratio was of 8.7. The mortality in patients with septic shock and lactate > 4.9 mmol/ is high and had a sensitivity of 90.9 % and specificity of 46.4 %.ConclusionsThe levels of serum lactate greater than four are associated to an increased risk of mortality in patients with septic shock.

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