Admission serum lactate is associated with all-cause mortality in the pediatric intensive care unit

Abstract

Objective: Our aim was to assess the relationship between serum lactate levels at intensive care unit (ICU) admission and all-cause mortality in the pediatric ICU.

Methods: We used the pediatric intensive care (PIC) database (a large pediatric intensive care database in China from 2010 to 2018) to conduct a retrospective analysis to evaluate the serum lactate levels at ICU admission of 12,213 critically ill children admitted to the ICU. We analyzed the association between serum lactate and all-cause mortality. Adjusted smoothing spline plots, subgroup analysis, and segmented multivariate logistic regression analysis were conducted to estimate the relative risk between proportional risk between serum lactate and all-cause mortality.

Results: Of the 12,213 children, 755 (6.18%) died. After fully adjusting for confounding factors, serum lactate was an independent risk factor for all-cause mortality in pediatric ICU (adjusted OR=1.14, 95% CI: 1.12, 1.17). The results of sensitivity analysis showed that in different stratified analyses, the effect of serum lactate on all-cause mortality remained stable.

Conclusions: Admission serum lactate is a risk factor, which is independent of the presence of acid-base disorders, inflammation, malnutrition, and renal or hepatic dysfunction, for all-cause mortality in the pediatric intensive care unit.

Keywords: Lactate; mortality; pediatric ICU.

Figure 1

Association between serum lactate and all-cause mortality. Note: Smooth fitting curve adjusted for gender, vasoactive drugs, age, intensive care unit category, pH, alanine aminotransferase, albumin, creatinine, activated partial thromboplastin time, total cholesterol, hemoglobin, white blood cell count. Red lines represent the spline plots of lactate concentration and blue lines represent the 95% confidence intervals of the spline plots.