Cumulative lactate and hospital mortality in ICU patients
| Autor: | Michael A. Kuiper, Lukas Brander, Peter E. Spronk, Sebastiaan P. A. Jansen, Johannes H. Rommes, Paul A. van Beest |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
CLEARANCE Population Critical Care and Intensive Care Medicine SERUM LACTATE law.invention Interquartile range law Internal medicine HYPERLACTATEMIA Medicine education Critically ill LACTIC-ACIDOSIS PREDICTORS education.field_of_study Intensive care units Receiver operating characteristic business.industry Septic shock Research SEPTIC SHOCK medicine.disease Intensive care unit SEVERE SEPSIS In-hospital mortality HEMODYNAMICS Lactic acidosis Emergency medicine Cardiology Arterial blood Lactate Hyperlactatemia business ORGAN FAILURE CRITICALLY-ILL PATIENTS |
| Zdroj: | Annals of Intensive Care Annals of Intensive Care, 3:6. SpringerOpen |
| ISSN: | 2110-5820 |
| DOI: | 10.1186/2110-5820-3-6 |
| Popis: | Background: Both hyperlactatemia and persistence of hyperlactatemia have been associated with bad outcome. We compared lactate and lactate-derived variables in outcome prediction.Methods: Retrospective observational study. Case records from 2,251 consecutive intensive care unit (ICU) patients admitted between 2001 and 2007 were analyzed. Baseline characteristics, all lactate measurements, and in-hospital mortality were recorded. The time integral of arterial blood lactate levels above the upper normal threshold of 2.2 mmol/L (lactate-time-integral), maximum lactate (max-lactate), and time-to-first-normalization were calculated. Survivors and nonsurvivors were compared and receiver operating characteristic (ROC) analysis were applied.Results: A total of 20,755 lactate measurements were analyzed. Data are srpehown as median [interquartile range]. In nonsurvivors (n = 405) lactate-time-integral (192 [0-1881] min.mmol/L) and time-to-first normalization (44.0 [0-427] min) were higher than in hospital survivors (n = 1846; 0 [0-134] min.mmol/L and 0 [0-75] min, respectively; all p 6 hours (mortality 16.6% vs. 24.4%; p 0.05). The area under the ROC curves for admission lactate and lactate-time-integral was not different (p = 0.36).Conclusions: Hyperlactatemia is associated with in-hospital mortality in a heterogeneous ICU population. In our patients, lactate peak values predicted in-hospital mortality equally well as lactate-time-integral of arterial blood lactate levels above the upper normal threshold. |
| Databáze: | OpenAIRE |
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