Serum Lactate as an Independent Predictor of In-Hospital Mortality in Intensive Care Patients

医学 重症监护室 优势比 置信区间 内科学 回顾性队列研究 逻辑回归 机械通风 死亡率 重症监护 重症监护医学
作者
Ralphe Bou Chebl,Hani Tamim,Gilbert Abou Dagher,Musharaf Sadat,Farhan Al Enezi,Yaseen M. Arabi
出处
期刊:Journal of Intensive Care Medicine [SAGE Publishing]
卷期号:35 (11): 1257-1264 被引量:32
标识
DOI:10.1177/0885066619854355
摘要

The aim of this study was to check if serum lactate was independently associated with mortality among critically ill patients.This was a single-center, retrospective cohort study. All adult patients (>18 years of age) who had at least 1 measurement of lactate within 24 hours of admission to intensive care unit (ICU) between January 2002 and December 2017 were included in the analysis. Patients were stratified into 3 groups: those with a serum lactate of <2 mmol/L (normal level), 2 to 4 mmol/L (intermediate level), and >4 mmol/L (high level). The primary outcome was in-hospital mortality. Secondary outcomes included ICU and hospital lengths of stay and mechanical ventilation duration. To determine the association between lactate level and hospital mortality, bivariate and multivariate logistic regression analyses were performed.Of the 16,447 patients admitted to the ICU, 8167 (49.65%) had normal levels, 4648 (28.26%) had an intermediate, and 3632 (22.09%) had high lactate levels. Hospital mortality was the highest in high lactate level, followed by the intermediate and the normal level group (47.4% vs 26.5% vs 19.6%; P < .0001). Intermediate and high lactate levels were independent predictors of hospital mortality (odds ratio [OR], 1.32; 95% confidence interval [CI]: 1.20-1.46, and 1.94; 95% CI, 1.75-2.16, respectively) as well as ICU mortality (OR, 1.47; 95% CI, 1.30-1.66 and 2.56; 95% CI, 2.27-2.88, respectively).Intensive care unit serum lactate is associated with increased ICU and hospital mortality, independent of comorbidities, organ dysfunction, or hemodynamic status.
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