The relationship between admission glucose and lactate with critical illness amongst adult patients presenting to the emergency department

Abstract

Aim: Our aim was to determine the relationship between glucose and lactate amongst adult patients admitted to hospital via the emergency department.

Method: We performed a cross-sectional observational study of 2541 patients admitted via the emergency department who had an admission glucose and lactate measurement available.

Results: 23% of the whole cohort had a diagnosis of diabetes. Glucose and lactate were predictors of the primary outcome of critical illness defined as composite of intensive care unit (ICU) admission or in-hospital death. In the multivariable analysis, lactate but not glucose remained an independent predictor of ICU/in hospital death in the group without diabetes. In the diabetes group, both glucose and lactate remained independent predictors of ICU admission/ in-hospital death.

Conclusions: Hyperglycaemia and hyperlactataemia are part of the metabolic response to critical illness. Lactate and a diagnosis of diabetes modify the relationship between glycaemia and critical illness.

Keywords: Critical illness; Diabetes; Emergency; Hyperglycaemia; Hyperlactataemia.