ArticleCritical care explorations2022
Prediction of Inhospital Mortality in Critically Ill Patients With Sepsis: Confirmation of the Added Value of 24-Hour Lactate to Acute Physiology and Chronic Health Evaluation IV.
Article in Critical care explorations, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Augmenting Mortality Prediction in Critically Ill Adults With Medication Data and Machine Learning Models.Critical care explorations · 2025Article
- Intensive care unit-based mortality risk model construction for severe fever with thrombocytopenia syndrome patients: a retrospective study.BMC infectious diseases · 2025Article
- Interpretable machine learning-based prediction of 28-day mortality in ICU patients with sepsis: a multicenter retrospective study.Frontiers in cellular and infection microbiology · 2024Article
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4 authors.
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Abstract
We previously reported the added value of 24-hour lactate concentration alone and in combination with 24-hour lactate clearance and lactate concentration at admission for the prediction of inhospital mortality in critically ill patients with sepsis. We aimed to validate this finding. DERIVATION COHORT: The derivation cohort from Leiden, The Netherlands, consisted of 451 critically ill patients with sepsis. VALIDATION COHORT: The validation cohort consisted of 4,440 critically ill adult patients with sepsis from the Medical Information Mart for Intensive Care cohort admitted to the ICU of Beth Israel Deaconness Medical Center, Boston, MA, between January 2006 and 2018. PREDICTION MODEL: Predictors of mortality were: age, chronic comorbidities, length of stay pre-ICU, Glasgow Coma Scale, and Acute Physiology Score. Lactate concentration at 24-hour alone, in combination with 24-hour lactate clearance and in combination with lactate concentration at admission, was added to assess improvement of the prediction model. The outcome was inhospital mortality.
resultsInhospital mortality occurred in 160 patients (36%) in the derivation cohort and in 2,347 patients (53%) in the validation cohort. The Acute Physiology and Chronic Health Evaluation (APACHE) IV model had a moderate discriminative performance (recalibrated
conclusionThe 24-hour lactate concentration and lactate concentration at admission contribute modestly to prediction of inhospital mortality in critically ill patients with sepsis. Future updates and possible modification of APACHE IV should consider the incorporation of lactate concentration at baseline and at 24 hours.
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