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. 2024 Nov 7;24(1):712.
doi: 10.1186/s12887-024-05200-4.

Relationship between lactate levels and 28-day mortality in pediatric sepsis: results from the pediatric intensive care database

Yongfu Song  1 , Na Wang  1 , Xiaofei Xie  1 , Yuxin Tian  1 , Yongji Wang  2
Affiliations

Relationship between lactate levels and 28-day mortality in pediatric sepsis: results from the pediatric intensive care database

Yongfu Song et al. BMC Pediatr. .

Abstract

Objective: This study aimed to investigate the relationship between serum lactate levels at admission to the intensive care unit (ICU) and the clinical outcomes of children with sepsis.

Methods: We used the Pediatric Intensive Care (PIC) database to identify 288 pediatric patients with sepsis. We analyzed the relationship between lactate levels and hospital and ICU mortality in sepsis by establishing a segmented multivariable Cox regression model. We also conducted subgroup analysis as well as analyzed the restricted cubic spline curves.

Results: After adjusting for all potential confounding factors, an increase of 1 mmol/L in lactate levels was found to be associated with an 17% rise in the 28-day hospital mortality risk among sepsis patients (HR: 1.17, 95% CI: 1.08-1.27, P = 0.0002). When considering lactate as a categorical variable, the mortality risk of patients with lactate levels ≥ 2.2 mmol/L was significantly increased (HR: 3.61, 95% CI: 1.24-10.54, P = 0.0189). The restricted cubic spline curve analysis revealed a nonlinear correlation between lactate and 28-day mortality, with an inflection point at 2.2 mmol/L. Similar findings were also observed in the assessment of secondary outcomes.

Conclusions: Our study demonstrates a non-linear correlation between lactate levels and 28-day mortality in pediatric sepsis, with a critical threshold of 2.2mmol/l for lactate levels in septic patients. Early assessment of lactate levels is recommended for children with sepsis to facilitate prompt intervention and mitigate the risk of fatality.

Keywords: Lactate; Mortality; PIC database; Pediatrics; Sepsis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the sample selection
Fig. 2
Fig. 2
Relationship between the lactate and the risk of 28-day mortality based on restricted cubic spline curves. (A) 28-day in hospital mortality. (B), 28-day in ICU mortality. The model was adjusted for age, sex, white blood cell count, red blood cell count, monocyte percentage, platelet count, lymphocyte percentage, serum sodium, serum calcium, chloride, PH, cephalosporin use, vasopressors use, liquid input, liquid output
Fig. 3
Fig. 3
Kaplan-Meier analysis for 28-day survival probability in pediatric sepsis. (A), Kaplan-Meier analysis of in-hospital mortality within 28 days; (B), Kaplan-Meier analysis of ICU mortality within 28 days
Fig. 4
Fig. 4
Association between the lactacte and the risk of 28-day mortality based on subgroup analyses. (A), 28-day in-hospital mortalty. (B), 28-day in-ICu mortality. The model was adjusted for age, sex, white blood cell count, red blood cell count, monocyte percentage, platelet count, lymphocyte percentage, serum sodium, serum calcium, chloride, PH, cephalosporin use, vasopressors use, liquid input, liquid output
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References

    1. Jia W, Zhang X, Sun R, Li P, Wang D, Gu X, et al. Value of modified qSOFA, glucose and lactate in predicting prognosis in children with sepsis in the PICU. Ann Med. 2024;56(1):2337714. - PMC - PubMed
    1. Cecconi M, Evans L, Levy M, Rhodes A. Sepsis and septic shock. Lancet. 2018;392(10141):75–87. - PubMed
    1. Santiago CD, Menezes AM, de Carvalho WB, Delgado AF. Epidemiologic challenges in sepsis to the developing countries. Pediatr Crit Care Med. 2013;14(3):336. - PubMed
    1. Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018;6(3):223–30. - PubMed
    1. Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, et al. Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current estimates and limitations. Am J Respir Crit Care Med. 2016;193(3):259–72. - PubMed

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