ArticlePloS one2020
Lactate indices as predictors of in-hospital mortality or 90-day survival after admission to an intensive care unit in unselected critically ill patients.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- The Efficacy of Sodium Bicarbonate Ringer's Solution and Lactate Ringer's Solution in Patients Undergoing Long-Term Abdominal Open Surgery: A Multicenter Prospective Randomized Controlled Study.Drug design, development and therapy · 2025Trial
- Hyperlactatemia associated with diabetic ketoacidosis in pediatric intensive care unit.BMC endocrine disorders · 2021Trial
- Prognostic value of the lactate-based modified cally score in postoperative gastric cancer patients admitted to the ICU.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- Lactate: elucidating its indispensable role in human health.Molecular cancer · 2026Review
- Nursing interventions and multidomain physiological trajectories in ARDS: a retrospective cohort study.Frontiers in medicine · 2026Article
- Survival Prediction in Septic ICU Patients: Integrating Lactate and Vasopressor Use with Established Severity Scores.Diseases (Basel, Switzerland) · 2025Article
- The impact of withholding and withdrawal life-sustaining treatment issues on patients with sepsis: a prospective, nationwide, multicenter cohort study.Scientific reports · 2025Article
- Value of modified qSOFA, glucose and lactate in predicting prognosis in children with sepsis in the PICU.Annals of medicine · 2024Article
- Evaluating Lactate and D-Dimer as Mortality Predictors of Paediatric Multiple Organ Dysfunction Syndrome: A Prospective Study in a Low-Middle Income Country.The Malaysian journal of medical sciences : MJMS · 2024Article
- Hierarchical Capability in Distinguishing Severities of Sepsis via Serum Lactate: A Network Meta-Analysis.Biomedicines · 2024Review
- Prognostic factors for patients with hematologic malignancies admitted to the intensive care unit: is allogeneic transplantation still a risk factor?Annals of hematology · 2023Article
- Article
- The prognostic value of delta-lactate in critically ill children.Journal of paediatrics and child health · 2023Article
- The combination of lactate level, lactate clearance and APACHE II score better predicts short-term outcomes in critically Ill patients: a retrospective cohort study.BMC anesthesiology · 2022Article
- Article
- Impact on outcomes of measuring lactates prior to ICU in unselected heterogeneous critically ill patients: A propensity score analysis.PloS one · 2022Article
- Machine Learning Prediction Models for Mortality in Intensive Care Unit Patients with Lactic Acidosis.Journal of clinical medicine · 2021Article
- Understanding critically ill sepsis patients with normal serum lactate levels: results from U.S. and European ICU cohorts.Scientific reports · 2021Article
- Significance of lactate clearance in septic shock patients with high bilirubin levels.Scientific reports · 2021Article
- Lactate is Associated with Increased 30-Day Mortality in Critically Ill Patients with Alcohol Use Disorder.International journal of general medicine · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
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Abstract
backgroundWe performed an exclusive study to investigate the associations between a total of 23 lactate-related indices during the first 24h in an intensive care unit (ICU) and in-hospital mortality.
methodsNine static and 14 dynamic lactate indices, including changes in lactate concentrations (Δ Lac) and slope (linear regression coefficient), were calculated from individual critically ill patient data extracted from the Multiparameter Intelligent Monitoring for Intensive Care (MIMIC) III database.
resultsData from a total of 781 ICU patients were extracted, consisted of 523 survivors and 258 non-survivors. The in-hospital mortality rate for this cohort was 33.0%. A multivariate logistic regression model identified maximal lactate concentration at 24h after ICU admission (max lactate at T24) as a significant predictor of in-hospital mortality (odds ratio = 1.431, 95% confidence interval [CI] = 1.278-1.604, p<0.001) after adjusting for predefined confounders (age, gender, sepsis, Elixhauser comorbidity score, mechanical ventilation, renal replacement therapy, vasopressors, ICU severity scores). Area under curve (AUC) for max lactate at T24 was larger (AUC = 0.776, 95% CI = 0.740-0.812) than other indices (p<0.001), comparable to an APACHE III score of 0.771. When combining max lactate at T24 with APACHE III, the AUC was increased to 0.815 (95% CI:0.783-0.847). The sensitivity, specificity, and positive and negative predictive values for the cut-off value of 3.05 mmol/L were 64.3%, 77.4%, 58.5%, and 81.5%, respectively. Kaplan-Myer survival curves of the max lactate at T24 for 90-day survival after admission to ICU demonstrated a significant difference according to the cut-off value (p<0.001).
conclusionsThese data indicate that the maximal arterial lactate concentration at T24 is a robust predictor of in-hospital mortality as well as 90-day survival in unselected ICU patients with predictive ability as comparable with APACHE III score.
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