Differential effect of lactate in predicting mortality in septic patients with or without disseminated intravascular coagulation: a multicenter, retrospective, observational study

Journal of Intensive Care

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[1] 0000 0001 0943 978X, grid.27476.30, Department of Biostatistics, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan;0000 0004 1761 798X, grid.256115.4, Department of Anesthesiology and Critical Care Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, 470-1192, Toyoake, Aichi, Japan;0000 0004 1761 798X, grid.256115.4, Laboratory for Immune Response and Regulatory Medicine, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan;Department of Anesthesiology, Nishichita General Hospital, Tokai, Aichi, Japan;

关键词: Sepsis;    Disseminated intravascular coagulation;    Lactate;    Mortality;   

DOI  :  10.1186/s40560-019-0389-x

来源: publisher

【 摘 要 】

BackgroundWe examined whether high lactate level in septic patients was associated with 90-day mortality based on the patients’ disseminated intravascular coagulation (DIC) status.MethodsWe conducted a multicenter, retrospective, observational study of patients admitted to the intensive care unit (ICU) with a suspicion of severe infection and diagnosed with sepsis. Regression analyses were performed to estimate the interaction effect between DIC status and the lactate level. Then, the association between the lactate level and 90-day mortality was assessed in the DIC and non-DIC subgroups.ResultsThe data of 415 patients were analyzed. We found a significant interaction between DIC status and the lactate level for predicting 90-day mortality (pinteraction = 0.04). Therefore, we performed a subgroup analysis and found that high lactate concentration was significantly associated with 90-day mortality in the DIC group (odds ratio = 2.31, p = 0.039) but not in the non-DIC group.ConclusionsIn patients with DIC, a high lactate level significantly predicted 90-day mortality; no such association was found in the non-DIC group. Thus, DIC status may serve as a possible effect modifier of lactate level in predicting mortality in patients with sepsis.

【 授权许可】

CC BY