The role of lactate clearance on deciding discharge in exacerbation of chronic obstructive pulmonary disease: Retrospective cohort study

Abstract

Aim: Patients presenting with chronic obstructive pulmonary disease (COPD) exacerbation in crowded emergency departments are often discharged with symptomatic treatment. This situation increases the number of patients admitted to the hospital and the number of attacks. It is very important to be able to predict hospitalization with cheap and easy blood parameters to be looked at the time of application. In our study, we aimed to investigate the relationship between lactate Clearance and admission or discharge decision in patients presenting with acute exacerbation of COPD.

Methods: In this study, patients over 18 years old who were admitted to Batman Regional State Hospital Emergency Department with COPD attack between January 1, 2014 and January 1, 2018 were retrospectively studied. The patients were divided into 2 groups. Group 1 included the patients who discharged after treatment in emergency, group 2 included the patients who hospitalized. Both groups were compared in terms of lactate clearance values.

Results: We studied 117 patients who met the criteria for inclusion in the study. Of these, 65 were discharged and 52 were hospitalized. Six of the hospitalized patients were hospitalized in the intensive care unit. Forty-one patients were female and 76 were male.  We did not find any difference between the first and last lactate values of patients who were admitted and discharged (p=0.345 and 0.829). However, the lactate clearances of the discharged patients were higher, while the lactate clearances of patients with hospitalization indications were lower (p<0.001).

Conclusion: We think that lactate clearance can be used as a marker in patients presenting emergency services with COPD exacerbation without deciding on discharge or admission.