Lactate Clearance and Outcome in Septic Shock Patients with Low Level of Initial Lactate.
10.4266/kjccm.2011.26.2.78
- Author:
Yun Su SIM
1
;
Cho Rom HAHM
;
So Yeon LIM
;
Gee Young SUH
;
Kyeongman JEON
Author Information
1. Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
lactic acid;
mortality;
prognosis;
septic shock
- MeSH:
Emergencies;
Follow-Up Studies;
Humans;
Lactic Acid;
Logistic Models;
Prognosis;
Retrospective Studies;
Sepsis;
Shock, Septic
- From:The Korean Journal of Critical Care Medicine
2011;26(2):78-82
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Serum lactate is a potentially useful biomarker to risk-stratify patients with severe sepsis and septic shock. However, there are only a few studies on the association of serum lactate levels and prognosis in septic shock patients with initial low lactate levels. METHODS: To evaluate whether initial and follow-up lactate levels associated with mortality in septic shock patients with low lactate level, we conducted a retrospective observational study of patients with septic shock, who were hospitalized through the emergency department in February-July 2008. Initial lactate level was stratified as low (<4 mmol/L) or high (> or =4 mmol/L). The primary outcome was 28-day mortality and multiple logistic regression analysis was used to adjust for potential confounders in the association between lactate clearance and mortality. RESULTS: Of 90 patients hospitalized with septic shock during the study period, 68 (76%) patients had low initial lactate. Mortality at 28 days was 18% in patients with low lactate level. In these patients, initial lactate level was not associated with mortality (p = 0.590). However, increased lactate at follow-up and lactate clearance were associated with mortality (p = 0.006, p = 0.002, respectively). In a multiple logistic regression analysis, increased mortality rate independently associated with age (OR 1.162, 95% CI 1.041-1.298) and lactate clearance (OR 0.654, 95% CI 0.498-0.859). CONCLUSIONS: In septic shock patients with a low lactate level, lactate clearance independently associated with a decreased mortality rate. Therefore, lactate clearance could be useful for predicting the outcome in these patients.
