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Lactate improves SAPS 3 prognostication.

P Andersson1,2, A Frigyesi1,2

  • 1Department of Clinical Sciences, Section for Anaesthesiology and Intensive Care, Lund University, Lund, Sweden.

Acta Anaesthesiologica Scandinavica
|November 11, 2017
PubMed
Summary
This summary is machine-generated.

Lactate levels independently predict mortality in intensive care, especially for cardiac arrest and sepsis patients. While not improving overall prognostication scores like SAPS 3, lactate offers valuable insights for specific critical conditions.

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Area of Science:

  • Critical Care Medicine
  • Prognostic Biomarkers
  • Intensive Care Unit (ICU) Management

Background:

  • Lactate concentration is a known mortality predictor in ICUs.
  • Current scoring systems like SAPS 3 do not incorporate lactate.
  • There is a need to evaluate lactate's prognostic value alongside existing scores.

Purpose of the Study:

  • To assess the prognostic value of lactate concentration.
  • To determine if lactate improves the SAPS 3 score's predictive accuracy.
  • To investigate lactate's role in specific patient groups like cardiac arrest and sepsis.

Main Methods:

  • Retrospective analysis of 3039 ICU patients admitted between 2008 and 2017.
  • Lactate levels measured within 1 hour of admission.
  • Statistical analysis including logistic regression and AUC comparison with SAPS 3.

Main Results:

  • Lactate concentration is an independent predictor of 30-day mortality (OR 1.08).
  • Lactate did not significantly improve the overall AUC for SAPS 3 (78.9% vs. 78.7%).
  • Lactate improved AUC for cardiac arrest (79.6% vs. 76.4%) and sepsis (75.1% vs. 72.7%).

Conclusions:

  • Lactate concentration is an independent mortality predictor across all diagnoses, cardiac arrest, and sepsis.
  • Adding lactate improved prognostication for cardiac arrest and sepsis patients.
  • Lactate enhances the prognostic capability of SAPS 3 for specific high-risk groups.