ArticleFrontiers in medicine2025
Phase-specific mortality risk of serum lactate thresholds in very low birth weight infants with late-onset sepsis: a retrospective cohort study.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Late-onset sepsis (LOS) in very low birth weight (VLBW) infants confers substantial mortality risk. While lactate monitoring is standard, validated prognostic thresholds for mortality remain unestablished in this population. Methods: This retrospective cohort study (2014-2024) analyzed 596 VLBW infants (≤32 weeks; <1,500 g) with LOS at a tertiary NICU. Multivariable regression and piecewise linear modeling identified lactate-mortality thresholds, adjusting for gestational age, respiratory failure severity, vasopressor requirement, and multiorgan dysfunction. Bootstrap validation (1,000 iterations) assessed threshold stability. Results: Mortality occurred in 21% (125/596). Nonlinear analysis revealed critical inflection points at 2.2 mmol/L (95%CI: 1.9-2.5) and 4.0 mmol/L (95%CI: 3.7-4.3) ( Conclusion: Lactate reveals phase-specific mortality associations in VLBW infants with LOS. The 7.0-fold mortality risk increase per mmol/L in the 2.2-4.0 mmol/L interval suggests potential metabolic resuscitation targets for precision monitoring in sepsis management.
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