Impact of Lactate on Disseminated Intravascular Coagulation in Patients with Severe Trauma.

Introduction: The association between elevated lactate levels and the development of disseminated intravascular coagulation (DIC) in patients with severe trauma remains unclear. Hence, this study aimed to explore the association between lactate and the development of DIC in patients with severe trauma. Methods: This prospective cohort study was conducted on consecutive patients with severe trauma who were hospitalized in the intensive care unit from January 2020 to January 2023. The primary outcome measured was the occurrence of DIC in patients in the emergency department or posthospitalization. Logistic regression analysis evaluating the risk values for lactate and DIC, the receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) examinations studying the predictive efficiency of lactate for DIC. The Kaplan-Meier survival curve was used to assess patient survival. Sensitivity robustness analysis included modified Poisson regression, Results: Logistic regression analysis corrected for confounding factors showed that lactate was a risk factor for DIC in patients with severe trauma (adjusted odds ratio [OR]: 1.374, 95% confidence interval [CI]: 1.206-1.566). Lactate predicted DIC risk with a 0.8513 area under the ROC curve (95% CI: 0.7827-0.9199), 4.8 cutoff value, 0.8333 sensitivity, and 0.8014 specificity. DCA showed the correlation between lactate and DIC. The mortality rate of patients with a high risk of DIC was significantly higher than that of patients with a low risk (log-rank test, Conclusions: Elevated lactate is closely associated with the occurrence of DIC in patients with severe trauma. Lactate seems to be a good predictive factor for DIC manifestation in patients with severe trauma.