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Published on: March 26, 2019
Association of Arterial Blood Lactate Trajectories with 7-Day Mortality in Patients with Traumatic Brain Injury
Lian Xie1,2, Xuezhi Shi2, Jiale Yang2
1Southern Medical University, Guangzhou, China.
Background:
While lactate has emerged as a promising biomarker for assessing the severity in traumatic brain injury (TBI), it fails to reflect the dynamic change of the disease. Thus, this study aims to investigate the relationship between arterial lactate trajectories and TBI.
Methods:
TBI patient data were extracted from the Medical Information Mart for Intensive Care IV database. The group-based trajectory modeling was employed to identify subgroups of lactate trajectories. Subsequently, the impact of lactate trajectories on mortality in TBI patients was analyzed using Cox proportional hazards models and doubly robust estimation methods.
Results:
Among 509 enrolled TBI patients, three lactate trajectories were established using group-based trajectory modeling. Kaplan-Meier analysis revealed that Trajectory 1 had the highest 7-day mortality. Multivariate Cox regression analysis showed that Trajectory 1 was an independent risk factor for 7-day mortality. The doubly robust analysis also similarly demonstrated that Trajectory 1 had a significantly higher mortality risk compared to other groups.
Conclusion:
Three lactate trajectories were found in TBI patients, and Trajectory 1 was identified as an independent risk factor for mortality. The study emphasizes the importance of dynamic monitoring to facilitate early identification and timely treatment of individuals in Trajectory 1 with potentially poor prognoses.
