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Original Article
Prognostic value of hyperlactatemia in infected patients admitted to intensive care units: a multicenter study
Rev Bras Ter Intensiva. 2022;34(1):154-162
Abstract
Original ArticlePrognostic value of hyperlactatemia in infected patients admitted to intensive care units: a multicenter study
Rev Bras Ter Intensiva. 2022;34(1):154-162
DOI 10.5935/0103-507X.20220010-en
Views1See moreABSTRACT
Objective:
To evaluate the influence of patient characteristics on hyperlactatemia in an infected population admitted to intensive care units and the influence of hyperlactatemia severity on hospital mortality.
Methods:
A post hoc analysis of hyperlactatemia in the INFAUCI study, a national prospective, observational, multicenter study, was conducted in 14 Portuguese intensive care units. Infected patients admitted to intensive care units with a lactate measurement in the first 12 hours of admission were selected. Sepsis was identified according to the Sepsis-2 definition accepted at the time of data collection. The severity of hyperlactatemia was classified as mild (2 – 3.9mmol/L), moderate (4.0 – 9.9mmol/L) or severe (> 10mmol/L).
Results:
In a total of 1,640 patients infected on admission, hyperlactatemia occurred in 934 patients (57%), classified as mild, moderate and severe in 57.0%, 34.4% and 8.7% of patients, respectively. The presence of hyperlactatemia and a higher degree of hyperlactatemia were both associated with a higher Simplified Acute Physiology Score II, a higher Charlson Comorbidity Index and the presence of septic shock. The lactate Receiver Operating Characteristic curve for hospital mortality had an area under the curve of 0.64 (95%CI 0.61 – 0.72), which increased to 0.71 (95%CI 0.68 – 0.74) when combined with Sequential Organ Failure Assessment score. In-hospital mortality with other covariates adjusted by Simplified Acute Physiology Score II was associated with moderate and severe hyperlactatemia, with odds ratio of 1.95 (95%CI 1.4 – 2.7; p < 0.001) and 4.54 (95%CI 2.4 - 8.5; p < 0.001), respectively.
Conclusion:
Blood lactate levels correlate independently with in-hospital mortality for moderate and severe degrees of hyperlactatemia.
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Case reports Child Coronavirus infections COVID-19 Critical care Critical illness Extracorporeal membrane oxygenation Infant, newborn Intensive care Intensive care units Intensive care units, pediatric mechanical ventilation Mortality Physical therapy modalities Prognosis Respiration, artificial Respiratory insufficiency risk factors SARS-CoV-2 Sepsis