Incidence and risk factors for hyperlactatemia in ED patients with acute metformin overdose.
Incidence and risk factors for hyperlactatemia in ED patients with acute metformin overdose.
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DOI：
10.1016/j.ajem.2019.03.033
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发表时间：
2019-12
期刊：
影响因子：
--
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中科院分区：
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--
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The goals of this study are to describe clinical characteristics and risk factors for metabolic acidosis with hyperlactatemia in emergency department (ED) patients with acute metformin overdose. This was a secondary analysis of data from a retrospective observational cohort of adult ED patients presenting with acute drug overdose at two tertiary care hospitals over 5 years. The primary outcomes were: (1) hyperlactatemia, defined as a lactate concentration ≥ 2 mmol/L at any point during hospital admission and, (2) metformin associated lactic acidosis (MALA), defined as a lactate concentration ≥5 mmol/L and pH <7.35 at any point during hospital admission. We screened 3739 acute overdoses; 2872 met eligibility, 56 self-reported metformin overdose (57% female, mean age 55.8). Of these, 39 had measured lactate values. There was a high incidence of hyperlactatemia (56.4%); MALA was less frequent (17.9%). There were no deaths. Low serum bicarbonate was an independent clinical risk factor for hyperlactatemia (adjusted p<0.05). Acetaminophen co-exposure was an independent clinical risk factor for MALA (OR 24.40, 95% CI 1.6–376.4). In ED patients with acute metformin overdose, initial hyperlactatemia is common but MALA is unusual. Acetaminophen co-exposure is a novel independent risk factor for the occurrence of MALA that deserves further investigation.
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影响因子：
6.2
作者：
Gilbert, EH;Lowenstein, SR;Steiner, J
通讯作者：
Steiner, J
DOI：
10.1186/cc9404
发表时间：
2011
期刊：
Critical care (London, England)
影响因子：
--
作者：
Vecchio S;Protti A
通讯作者：
Protti A
影响因子：
3.5
作者：
Shaw, J. S.;Wilmot, R. L.;Kilpatrick, E. S.
通讯作者：
Kilpatrick, E. S.
影响因子：
2.8
作者：
Forrester, M. B.
通讯作者：
Forrester, M. B.
影响因子：
3.3
作者：
Gummin, David D.;Mowry, James B.;Banner, William
通讯作者：
Banner, William