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Herein, our results will provide new insights in RA diagnosis however, the underlying mechanisms need to be further explored.Objective The clinical interpretation of lactate ≤ 2.00 mmol/L in emergency department (ED) patients is not well-characterized. This study aims to determine the optimal cutoff value for lactate within the reference range that predicts in-hospital mortality among ED patients. Methods This was a retrospective study of adult patients presenting to a tertiary ED with an initial serum lactate level of less then 2.00 m