• Francisco Martín-Rodríguez, Raúl López-Izquierdo, Miguel A Castro Villamor, Mangas Iratxe Moro IM Emergency Department, Valladolid University Clinic, SACYL, Spain., Pablo Del Brío Ibáñez, Juan F Delgado Benito, José L Martín Conty, Jesús Álvarez Manzanares, Agustín Mayo-Iscar, and Carlos Del Pozo Vegas.
• Advanced Clinical Simulation Center, Department of Medicine, Dermatology and Toxicology, Faculty of Medicine, University of Valladolid, Avda. Ramón y Cajal, 7, 47005 Valladolid, Spain; Prehospital Emergency Medical Services, Advanced Medical Life Support, SACYL, Castilla y León, Spain. Electronic address: fmartin@saludcastillayleon.es.
• Am J Emerg Med. 2019 Sep 1; 37 (9): 1627-1632.

BackgroundPrehospital Emergency Medical Services must attend to patients with complex physiopathological situations with little data and in the shortest possible time. The objective of this work was to study lactic acid values and their usefulness in the prehospital setting to help in clinical decision-making.Study DesignWe conducted a longitudinal prospective, observational study on patients over 18 years of age who, after being evaluated by the Advanced Life Support Unit, were taken to the hospital between April and June 2018. We analyzed demographic variables, prehospital lactic acid values and early mortality (<30 days). The area under the curve of the receiver operating characteristic was calculated for the prehospital value of lactic acid.ResultsA total of 279 patients were included in our study. The median age was 68 years (interquartile range: 54-80 years). Overall 30-day mortality was 9% (25 patients). The area under the curve for lactic acid to predict overall mortality at 30 days of care was 0.82 (95% CI: 0.76-0.89). The lactate value with the best sensitivity and specificity overall was 4.25 mmol/L with a sensitivity of 84% (95% CI: 65.3-93.6) and specificity of 70% (95% CI: 65.0-76.1).ConclusionsThe level of lactic acid can be a complementary tool in the field of prehospital emergencies that will guide us early in the detection of critical patients.Copyright © 2018 Elsevier Inc. All rights reserved.

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