Serum Lactate: An Early Screening Tool for Pediatric Emergency Disposition – A Single-Center Retrospective Study

Objective Lactate is a critical byproduct of septic shock and tissue hypoperfusion. Elevated lactate levels are often observed in critically ill patients and may indicate poor outcomes. The study aimed to evaluate the prognostic significance of serum lactate levels in predicting clinical deterioration and pediatric intensive care unit (PICU) admission. Methods A retrospective study was conducted involving children admitted through the pediatric emergency department at King Faisal Specialist Hospital and Research Center between December 2020 and January 2023. Participants included children aged 3 months to 14 years with no history of metabolic disorders. Results A total of 90 patients (40 male and 50 female) with a mean age of 5.22 years (± 4.4 SD) were included. Among them, 24 children had a history of cardiac conditions, and 26 had oncological comorbidities. Forty-eight patients (53%) were admitted to the ward, whereas 42 (47%) required PICU admission. Initial lactate levels were significantly elevated in PICU-admitted patients (P < 0.000). Younger age (P < 0.000) and cardiac comorbidities (P = 0.013) were strongly associated with PICU admission. Mortality rates were significantly higher in PICU-admitted patients than in ward-admitted patients (P = 0.013). Conclusion Serum lactate levels serve as a valuable prognostic marker for predicting hospital stay and PICU admission. Additionally, younger age and cardiac comorbidities are significant factors associated with increased PICU admission