Risk factors for mortality in patients with low lactate level and septic shock

Oh, Dong Hyun; Kim, Moo Hyun; Jeong, Woo Yong; Kim, Yong Chan; Kim, Eun Jin; Song, Je Eun; Jung, In Young; Jeong, Su Jin; Ku, Nam Su; Choi, Jun Yong; Song, Young Goo; Kim, June Myung

doi:10.1016/j.jmii.2017.08.009

Cited by 26 publications

(23 citation statements)

References 33 publications

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“…However, although initial elevated lactate was an independent risk factor for mortality, its predictive value was not sufficient in our study. Conversely, Oh et al suggested that despite low arterial lactate, patients with a high APACHE II score, had a poorer prognosis [ 37 ]. Although lactate levels were intravenously tested in our study.…”

Section: Discussionmentioning

confidence: 99%

Pentraxin-3, procalcitonin and lactate as prognostic markers in patients with sepsis and septic shock

Zhou

Liu

et al. 2017

Oncotarget

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The purpose of this study was to confirm the prognostic value of pentraxin-3 (PTX3), procalcitonin (PCT) and lactate in patients with severe infections requiring ICU management and to develop and validate a model to enhance mortality prediction by combining severity scores with biomarkers. We included 141 patients with the diagnosis of sepsis/septic shock. The levels of PTX3, PCT and lactate were measured on day 0, 3, 7 of hospitalization and Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were also evaluated. The influence of these variables on 28-day mortality was evaluated. The 28-day mortality rate in this study was 28.8%. The baseline levels of PTX3, PCT and lactate in the non-survival group were higher than in the survival group (P < 0.05 for all). Pearson's correlation found that PTX3, PCT and lactate were all positively correlated with SOFA and APACHE II scores (P <0.01 for all). Univariate and multivariate Cox regression revealed that PTX3, PCT and lactate were independently associated with 28-day mortality. The models combining above three biomarkers performed better predictive property than each individual one as determined by receiver operating characteristic (ROC) analysis. In summary, our results suggest that PTX3, PCT and lactate could serve as clinically informative biomarkers of disease severity and patient outcome in sepsis/septic shock. A model combining PTX3, PCT and lactate improves mortality prediction in these patients.

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Section: Discussionmentioning

confidence: 99%

Pentraxin-3, procalcitonin and lactate as prognostic markers in patients with sepsis and septic shock

Zhou

Liu

et al. 2017

Oncotarget

View full text Add to dashboard Cite

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“…Serum lactate was identi ed as another risk factor associated with in-hospital death in our study. Lactate has been used as a prognostic marker in predicting the severity and outcome of sepsis and septic shock [25]. Shankar-Hari et al suggested in their study that the adjusted odds ratio for hospital mortality increased linearly with lactate levels with lactate level > 2 mmol/L being the cutoff value for the diagnosis of septic shock [26].…”

Section: Discussionmentioning

confidence: 99%

Identification of risk factors for in-hospital death of COVID - 19 pneumonia -- lessions from the early outbreak

Wang

2020

Preprint

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Objective: To examine the clinical characteristics and identify independent risk factors for in-hospital mortality of 2019 novel coronavirus (COVID-19) pneumonia.Methods: A total of 156 patients diagnosed with COVID-19 pneumonia at the central Hospital of Wuhan from January 29, 2020, to March 20, 2020 and 20 healthy individuals were enrolled in this single-centered retrospective study. The epidemiological parameters, clinical presentations, underlying diseases, laboratory test results and disease outcomes were collected and analyzed. Results: The median age of all enrolled patients was 66 years. At least one underlying disease was identified in 101 COVID-19 patients, with hypertension being the most common one, followed by cardiovascular disease and diabetes. The most common symptoms identified upon admission were fever, cough, dyspnea and fatigue. Compared to survival cases, patients who dead during hospitalization had higher plasma levels of D-dimer, creatinine, creatine kinase, lactate dehydrogenase, lactate and lower percentage of lymphocytes (LYM [%]), platelet count and albumin levels. Most enrolled patients received anti-biotics and anti-viral treatment. In addition, 60 patients received corticosteroid and 51 received intravenous immunoglobulin infusion. 44 patients received noninvasive ventilation and 19 received invasive ventilation. Respiratory failure was the most frequently observed complication (106 [67.9%]), followed by sepsis (103 [66.0%]), acute respiratory distress syndrome (ARDS) (67 [42.9%]) and septic shock (50 [32.1%]). Multivariable regression suggested that advanced age (OR [odds ratio]=1.098, 95% CI [confidence interval]: 1.006-1.199, P=0.037), shorter duration from onset to admission (OR= 0.853, 95% CI: 0.750-0.969, P=0.015) and elevated lactate level upon admission (OR= 2.689, 95% CI: 1.044-6.926, P=0.040) were independent risk factors for in-hospital mortality for COVID-19 infection. Meanwhile, increased LYM (%) at admission (OR= 0.787, 95% CI: 0.686-0.903, P=0.001) indicated a better prognosis. Conclusions: In this study, we discovered that age, duration from onset to admission, LYM (%) and lactate level upon admission were independent factors that affecting in-hospital mortality rate.

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“…Serum lactate was identi ed as another risk factor associated with in-hospital death in our study. Lactate has been used as a prognostic marker in predicting the severity and outcome of sepsis and septic shock [28]. Shankar-Hari et al suggested in their study that the adjusted odds ratio for hospital mortality increased linearly with increasing lactate levels with lactate level > 2 mmol/L being the cutoff value for the diagnosis of septic shock [29].…”

Section: Discussionmentioning

confidence: 99%

Identification of Risk Factors for in-Hospital Death of COVID - 19 Pneumonia

Wang

2020

Preprint

View full text Add to dashboard Cite

Objective: To examine the clinical characteristics and identify independent risk factors for in-hospital mortality of 2019 novel coronavirus (COVID-19) pneumonia.Methods: A total of 156 patients diagnosed with COVID-19 pneumonia at the central Hospital of Wuhan from January 29, 2020, to March 20, 2020 were enrolled in this single-centered retrospective study. Their epidemiological parameters, clinical presentations, underlying diseases, laboratory test results and disease outcomes were collected and analyzed.Results: The median age of enrolled patients was 66. Underlying diseases were identified in 101 patients, with hypertension being the most common one, followed by cardiovascular disease and diabetes. The most common symptoms identified upon admission were fever, cough, dyspnea and fatigue. Compared to survival cases, patients who dead during hospitalization had higher plasma levels of D-dimer, creatinine, creatine kinase, lactate dehydrogenase, lactate and lower percentage of lymphocytes (LYM [%]), platelet count and albumin levels. Most enrolled patients received anti-biotics and anti-viral treatment. In addition, 60 patients received corticosteroid and 51 received intravenous immunoglobulin infusion. 44 patients received noninvasive ventilation, 19 received invasive ventilation. Respiratory failure was the most frequently observed complication (106 [67.9%]), followed by sepsis (103 [66.0%]), acute respiratory distress syndrome (ARDS) (67 [42.9%]) and septic shock (50 [32.1%]). Multivariable regression suggested that advanced age (OR [odds ratio]= 1.059, 95% CI [confidence interval]: 1.011-1.110, P= 0.016) and elevated lactate level upon admission (OR= 2.411, 95% CI: 1.177-4.941, P= 0.016) were independent risk factors for in-hospital mortality for COVID-19 infection. Meanwhile, increased LYM (%) at admission (OR= 0.798, 95% CI: 0.728-0.876, P< 0.001) indicated a better prognosis. Conclusions: In this study, we discovered that age, LYM (%) and lactate level upon admission were independent factors that could influence in-hospital mortality rate.

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Risk factors for mortality in patients with low lactate level and septic shock

Abstract: Arterial lactate is a very reliable diagnostic and prognostic predictor of septic shock. However, despite low arterial lactate, patients with a high APACHEⅡ score, high C-reactive protein levels, and chronic heart failure had a poorer prognosis.

Cited by 26 publications

References 33 publications

Pentraxin-3, procalcitonin and lactate as prognostic markers in patients with sepsis and septic shock

Pentraxin-3, procalcitonin and lactate as prognostic markers in patients with sepsis and septic shock

Identification of risk factors for in-hospital death of COVID - 19 pneumonia -- lessions from the early outbreak

Identification of Risk Factors for in-Hospital Death of COVID - 19 Pneumonia

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