Prognostic values of serum lactate-to-bicarbonate ratio and lactate for predicting 28-day in-hospital mortality in children with dengue shock syndrome.

Autor:	Nguyen Tat T; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam.; Woolcock Institute of Medical Research, Ho Chi Minh City, Vietnam.; Faculty of Medicine, Texila American University, Georgetown, Guyana., Vo Hoang-Thien N; University of Medical Center, Ho Chi Minh City, Vietnam., Nguyen Tat D; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam.; Faculty of Medicine, Texila American University, Georgetown, Guyana., Nguyen PH; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam., Ho LT; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam., Doan DH; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam., Phan DT; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam., Duong YN; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam., Nguyen TH; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam., Nguyen TK; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam., Dinh HT; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam., Dinh TT; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam., Pham AT; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam., Do Chau V; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam., Trinh TH; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam., Vo Thanh L; Department of Infectious Diseases, Children's Hospital No.2, Ho Chi Minh City, Vietnam.
Jazyk:	angličtina
Zdroj:	Medicine [Medicine (Baltimore)] 2024 Apr 26; Vol. 103 (17), pp. e38000.
DOI:	10.1097/MD.0000000000038000
Abstrakt:	This study aimed to assess the clinical utility of blood lactate-to-bicarbonate (L/B) ratio, as a prognostic factor for 28-day in-hospital mortality in children with dengue shock syndrome (DSS), admitted to the pediatric intensive care unit (PICU). This single-center retrospective study was conducted at a tertiary children hospital in southern Vietnam from 2013 to mid-2022. Prognostic models for DSS mortality were developed, using a predefined set of covariates in the first 24 hours of PICU admission. Area under the curves (AUCs), multivariable logistic and Least Absolute Shrinkage and Selection Operator (LASSO) regressions, bootstrapping and calibration slope were performed. A total of 492 children with DSS and complete clinical and biomarker data were included in the analysis, and 26 (5.3%) patients died. The predictive values for DSS mortality, regarding lactate showing AUC 0.876 (95% CI, 0.807-0.944), and that of L/B ratio 0.867 (95% CI, 0.80-0.934) (P values of both biomarkers < .001). The optimal cutoff point of the L/B ratio was 0.25, while that of lactate was 4.2 mmol/L. The multivariable model showed significant clinical predictors of DSS fatality including severe bleeding, cumulative amount of fluid infused and vasoactive-inotropic score (>30) in the first 24 hours of PICU admission. Combined with the identified clinical predictors, the L/B ratio yielded higher prognostic values (odds ratio [OR] = 8.66, 95% confidence interval [CI], 1.96-38.3; P < .01) than the lactate-based model (OR = 1.35, 95% CI, 1.15-1.58; P < .001). Both the L/B and lactate models showed similarly good performances. Considering that the L/B ratio has a better prognostic value than the lactate model, it may be considered a potential prognostic biomarker in clinical use for predicting 28-day mortality in PICU-admitted children with DSS. Competing Interests: The authors have no funding and conflicts of interest to disclose. (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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