The Association Between Tachycardia and Mortality in Septic Shock Patients According to Serum Lactate Level: A Nationwide Multicenter Cohort Study
10.3346/jkms.2023.38.e313
- Author:
Soo Jin NA
1
;
Dong Kyu OH
;
Sunghoon PARK
;
Yeon Joo LEE
;
Sang-Bum HONG
;
Mi Hyeon PARK
;
Ryoung-Eun KO
;
Chae-Man LIM
;
Kyeongman JEON
;
On behalf of the Korean Sepsis Alliance (KSA) Investigators
Author Information
1. Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Publication Type:Original Article
- From:Journal of Korean Medical Science
2023;38(40):e313-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:This study aimed to evaluate whether the effect of tachycardia varies according to the degree of tissue perfusion in septic shock.
Methods:Patients with septic shock admitted to the intensive care units were categorized into the tachycardia (heart rate > 100 beats/min) and non-tachycardia (≤ 100 beats/min) groups. The association of tachycardia with hospital mortality was evaluated in each subgroup with low and high lactate levels, which were identified through a subpopulation treatment effect pattern plot analysis.
Results:In overall patients, hospital mortality did not differ between the two groups (44.6% vs. 41.8%, P = 0.441), however, tachycardia was associated with reduced hospital mortality rates in patients with a lactate level ≥ 5.3 mmol/L (48.7% vs. 60.3%, P = 0.030; adjusted odds ratio [OR], 0.59, 95% confidence interval [CI], 0.35–0.99, P = 0.045), not in patients with a lactate level < 5.3 mmol/L (36.5% vs. 29.7%, P = 0.156; adjusted OR, 1.39, 95% CI, 0.82–2.35, P = 0.227).
Conclusion:In septic shock patients, the effect of tachycardia on hospital mortality differed by serum lactate level. Tachycardia was associated with better survival in patients with significantly elevated lactate levels.
