# Variations in capillary and serum lactates levels based on different etiologies of septic patients in the emergency department

## TL;DR

This study found that capillary and serum lactate levels vary depending on the cause of sepsis in emergency department patients.

## Contribution

The study identifies specific biomarker variations linked to different sepsis etiologies for better early prediction and treatment.

## Key findings

- Capillary and serum lactate levels were highest in Gram-positive infections.
- Neutrophil-to-lymphocyte ratio was higher in Gram-negative infections.
- Diastolic shock index increased in fungal infections.

## Abstract

Sepsis is a life-threating and time-depending condition. This study examined the association between sepsis etiology and variations in capillary and serum lactate levels, neutrophil-to-lymphocyte ratio, and diastolic shock index in emergency department patients.

This study, conducted between 2021 and 2022 at the Emergency Department of Ferrara, included the following criteria: (i) clinical suspect of infectious disease; (ii) qSOFA ≥2; (iii) age ≥18 years; (iv) signed informed consent. Etiologies were: (i) negative cultures (NC); (ii) Gram positive (GP); (iii) Gram negative (GN); (iv) fungal infections (FI).

Among the 200 included patients, 104 (52.0%) had NC, 36 (18.0%) GP, 53 (26.5%) GN and 7 (3.5%) FI. CLs (p = 0.006) and SLs (p < 0.001) were different according to etiology being higher in GP infections. NLR (p = 0.035) was higher in GN infections, while DSI (p = 0.008) increased in FI. Mortality was not influenced by the etiology.

All parameters differed according to sepsis etiology, thus improving early prediction of sepsis etiology and its pharmacological management.