Prognostic value of lactate levels and lactate clearance in sepsis and septic shock with initial hyperlactatemia: A retrospective cohort study according to the Sepsis-3 definitions
DC Field | Value | Language |
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dc.contributor.author | Lee, S.G. | - |
dc.contributor.author | Song, J. | - |
dc.contributor.author | Park, D.W. | - |
dc.contributor.author | Moon, S. | - |
dc.contributor.author | Cho, H.-J. | - |
dc.contributor.author | Kim, J.Y. | - |
dc.contributor.author | Park, J. | - |
dc.contributor.author | Cha, J.H. | - |
dc.date.accessioned | 2021-12-03T18:41:50Z | - |
dc.date.available | 2021-12-03T18:41:50Z | - |
dc.date.created | 2021-08-31 | - |
dc.date.issued | 2021-02 | - |
dc.identifier.issn | 0025-7974 | - |
dc.identifier.uri | https://scholar.korea.ac.kr/handle/2021.sw.korea/129181 | - |
dc.description.abstract | ABSTRACT: The 2016 Surviving Sepsis Campaign guidelines suggest guiding resuscitation to normalize lactate levels in patients with sepsis-associated hyperlactatemia as a marker of tissue hypoperfusion. This study evaluated the prognostic value of lactate levels and lactate clearance for 30-day mortality in patients with sepsis and septic shock diagnosed in the emergency department.We performed a retrospective cohort study of sepsis patients with initial lactate levels of ≥2 mmol/L. All patients met the Sepsis-3 definitions. The prognostic value of 6-hour lactate levels, 6-hour lactate clearance, 6-hour lactate metrics (≥2 mmol/L), and lactate clearance metrics (<10%, <20%, and <30%) was evaluated. We compared the sensitivity and specificity between metrics.Of the 363 sepsis and septic shock patients, 148 died (30-day mortality: 40.8%). Nonsurvivors had significantly higher 6-hour lactate levels and lower 6-hour lactate clearance than those of survivors. Six-hour lactate levels and 6-hour lactate clearance were associated with 30-day mortality after adjusting for potential confounders (odds ratio, 1.191 [95% confidence interval (CI), 1.097-1.294] and 0.989 [0.983-0.995], respectively). Six-hour lactate levels had better prognostic value than 6-hour lactate clearance (area under the curve, 0.720 [95% CI, 0.670-0.765] vs 0.656 [0.605-0.705]; P = .02). Six-hour lactate levels of ≥3.5 mmol/L and 6-hour lactate clearance of <24.4% were the optimal cut-off value in predicting the 30-day mortality. The prognostic value of 6-hour lactate metrics and 6-hour lactate clearance metrics did not differ. Six-hour lactate levels (≥2 mmol/L) had the highest sensitivity (89.2%).Six-hour lactate levels proved to be more accurate in predicting 30-day mortality than 6-hour lactate clearance and initial lactate levels. Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. | - |
dc.language | English | - |
dc.language.iso | en | - |
dc.publisher | NLM (Medline) | - |
dc.title | Prognostic value of lactate levels and lactate clearance in sepsis and septic shock with initial hyperlactatemia: A retrospective cohort study according to the Sepsis-3 definitions | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | Song, J. | - |
dc.contributor.affiliatedAuthor | Park, D.W. | - |
dc.contributor.affiliatedAuthor | Cho, H.-J. | - |
dc.identifier.doi | 10.1097/MD.0000000000024835 | - |
dc.identifier.scopusid | 2-s2.0-85102218176 | - |
dc.identifier.wosid | 000658982900090 | - |
dc.identifier.bibliographicCitation | Medicine, v.100, no.7, pp.e24835 | - |
dc.relation.isPartOf | Medicine | - |
dc.citation.title | Medicine | - |
dc.citation.volume | 100 | - |
dc.citation.number | 7 | - |
dc.citation.startPage | e24835 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.description.isOpenAccess | N | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | General & Internal Medicine | - |
dc.relation.journalWebOfScienceCategory | Medicine, General & Internal | - |
dc.subject.keywordPlus | CAMPAIGN INTERNATIONAL GUIDELINES | - |
dc.subject.keywordPlus | OXYGEN DELIVERY | - |
dc.subject.keywordPlus | ORGAN FAILURE | - |
dc.subject.keywordPlus | MORTALITY | - |
dc.subject.keywordPlus | MANAGEMENT | - |
dc.subject.keywordAuthor | lactate | - |
dc.subject.keywordAuthor | lactate clearance | - |
dc.subject.keywordAuthor | mortality | - |
dc.subject.keywordAuthor | sepsis | - |
dc.subject.keywordAuthor | septic shock | - |
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