{"title":"血清乳酸动力学作为脓毒症死亡率预测指标的意义研究。","authors":"Mit Chaudhari, Nagina Agarwal","doi":"10.5005/jp-journals-10071-23935","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis is one of the leading causes of death worldwide. Serum lactate is being used in sepsis for diagnostic and prognostic purposes for years now. In this study, we shed light over a novel use of lactate in form of various clearance parameters to determine mortality in septic patients at the 28th day.</p><p><strong>Materials and methods: </strong>In our study, 200 patients with sepsis were included using quick sequential organ failure assessment (qSOFA) score and their lactate levels were measured at the time of admission (0 hour) and 24 hours after admission. Lactate clearance parameters (absolute and relative lactate clearance, lactate clearance rate) were calculated. All patients were followed up for a period of 28 days to determine the outcome, and data analysis was done accordingly.</p><p><strong>Results and conclusion: </strong>Our study showed that higher SOFA score, qSOFA score, and serum lactate levels were associated with increased 28th-day mortality. Low absolute, relative lactate clearance and lactate clearance rate were also associated with poor outcomes. The best cutoffs to predict poor outcomes were serum lactate level at 24 hours ≥4 mmol/L and relative lactate clearance ≤40.3% with good sensitivity and specificity.</p><p><strong>How to cite this article: </strong>Chaudhari M, Agarwal N. Study of Significance of Serum Lactate Kinetics in Sepsis as Mortality Predictor. Indian J Crit Care Med 2022;26(5):591-595.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"591-595"},"PeriodicalIF":1.5000,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/4a/ijccm-26-591.PMC9160631.pdf","citationCount":"5","resultStr":"{\"title\":\"Study of Significance of Serum Lactate Kinetics in Sepsis as Mortality Predictor.\",\"authors\":\"Mit Chaudhari, Nagina Agarwal\",\"doi\":\"10.5005/jp-journals-10071-23935\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Sepsis is one of the leading causes of death worldwide. Serum lactate is being used in sepsis for diagnostic and prognostic purposes for years now. 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The best cutoffs to predict poor outcomes were serum lactate level at 24 hours ≥4 mmol/L and relative lactate clearance ≤40.3% with good sensitivity and specificity.</p><p><strong>How to cite this article: </strong>Chaudhari M, Agarwal N. Study of Significance of Serum Lactate Kinetics in Sepsis as Mortality Predictor. 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引用次数: 5
摘要
简介:败血症是世界范围内导致死亡的主要原因之一。多年来,血清乳酸被用于败血症的诊断和预后目的。在这项研究中,我们阐明了乳酸盐在各种清除参数形式的新用途,以确定感染性疾病患者第28天的死亡率。材料与方法:本研究采用快速顺序脏器功能衰竭评分法(qSOFA)纳入200例脓毒症患者,分别于入院时(0小时)和入院后24小时测定其乳酸水平。计算乳酸清除率参数(绝对乳酸清除率、相对乳酸清除率、乳酸清除率)。所有患者随访28天以确定结果,并据此进行数据分析。结果和结论:我们的研究表明,较高的SOFA评分、qSOFA评分和血清乳酸水平与28天死亡率增加有关。低绝对、相对乳酸清除率和乳酸清除率也与不良预后相关。预测不良预后的最佳临界值为24小时血清乳酸水平≥4 mmol/L,相对乳酸清除率≤40.3%,具有良好的敏感性和特异性。Chaudhari M, Agarwal N.血清乳酸动力学在脓毒症中作为死亡率预测因子的意义研究。中华检验医学杂志;2009;26(5):591-595。
Study of Significance of Serum Lactate Kinetics in Sepsis as Mortality Predictor.
Introduction: Sepsis is one of the leading causes of death worldwide. Serum lactate is being used in sepsis for diagnostic and prognostic purposes for years now. In this study, we shed light over a novel use of lactate in form of various clearance parameters to determine mortality in septic patients at the 28th day.
Materials and methods: In our study, 200 patients with sepsis were included using quick sequential organ failure assessment (qSOFA) score and their lactate levels were measured at the time of admission (0 hour) and 24 hours after admission. Lactate clearance parameters (absolute and relative lactate clearance, lactate clearance rate) were calculated. All patients were followed up for a period of 28 days to determine the outcome, and data analysis was done accordingly.
Results and conclusion: Our study showed that higher SOFA score, qSOFA score, and serum lactate levels were associated with increased 28th-day mortality. Low absolute, relative lactate clearance and lactate clearance rate were also associated with poor outcomes. The best cutoffs to predict poor outcomes were serum lactate level at 24 hours ≥4 mmol/L and relative lactate clearance ≤40.3% with good sensitivity and specificity.
How to cite this article: Chaudhari M, Agarwal N. Study of Significance of Serum Lactate Kinetics in Sepsis as Mortality Predictor. Indian J Crit Care Med 2022;26(5):591-595.