Differential effect of lactate in predicting mortality in septic patients with or without disseminated intravascular coagulation

A multicenter, retrospective, observational study

Daisuke Hasegawa, Kazuki Nishida, Yoshitaka Hara, Takahiro Kawaji, Kazuhiro Moriyama, Yasuyo Shimomura, Daisuke Niimi, Hidefumi Komura, Osamu Nishida

研究成果: Article

抄録

Background: We examined whether high lactate level in septic patients was associated with 90-day mortality based on the patients' disseminated intravascular coagulation (DIC) status. Methods: We conducted a multicenter, retrospective, observational study of patients admitted to the intensive care unit (ICU) with a suspicion of severe infection and diagnosed with sepsis. Regression analyses were performed to estimate the interaction effect between DIC status and the lactate level. Then, the association between the lactate level and 90-day mortality was assessed in the DIC and non-DIC subgroups. Results: The data of 415 patients were analyzed. We found a significant interaction between DIC status and the lactate level for predicting 90-day mortality (p interaction = 0.04). Therefore, we performed a subgroup analysis and found that high lactate concentration was significantly associated with 90-day mortality in the DIC group (odds ratio = 2.31, p = 0.039) but not in the non-DIC group. Conclusions: In patients with DIC, a high lactate level significantly predicted 90-day mortality; no such association was found in the non-DIC group. Thus, DIC status may serve as a possible effect modifier of lactate level in predicting mortality in patients with sepsis.

元の言語English
記事番号2
ジャーナルJournal of Intensive Care
7
発行部数1
DOI
出版物ステータスPublished - 24-06-2019

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Disseminated Intravascular Coagulation
Observational Studies
Lactic Acid
Retrospective Studies
Mortality
Sepsis
Intensive Care Units
Odds Ratio
Regression Analysis
Infection

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

これを引用

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title = "Differential effect of lactate in predicting mortality in septic patients with or without disseminated intravascular coagulation: A multicenter, retrospective, observational study",
abstract = "Background: We examined whether high lactate level in septic patients was associated with 90-day mortality based on the patients' disseminated intravascular coagulation (DIC) status. Methods: We conducted a multicenter, retrospective, observational study of patients admitted to the intensive care unit (ICU) with a suspicion of severe infection and diagnosed with sepsis. Regression analyses were performed to estimate the interaction effect between DIC status and the lactate level. Then, the association between the lactate level and 90-day mortality was assessed in the DIC and non-DIC subgroups. Results: The data of 415 patients were analyzed. We found a significant interaction between DIC status and the lactate level for predicting 90-day mortality (p interaction = 0.04). Therefore, we performed a subgroup analysis and found that high lactate concentration was significantly associated with 90-day mortality in the DIC group (odds ratio = 2.31, p = 0.039) but not in the non-DIC group. Conclusions: In patients with DIC, a high lactate level significantly predicted 90-day mortality; no such association was found in the non-DIC group. Thus, DIC status may serve as a possible effect modifier of lactate level in predicting mortality in patients with sepsis.",
author = "Daisuke Hasegawa and Kazuki Nishida and Yoshitaka Hara and Takahiro Kawaji and Kazuhiro Moriyama and Yasuyo Shimomura and Daisuke Niimi and Hidefumi Komura and Osamu Nishida",
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T1 - Differential effect of lactate in predicting mortality in septic patients with or without disseminated intravascular coagulation

T2 - A multicenter, retrospective, observational study

AU - Hasegawa, Daisuke

AU - Nishida, Kazuki

AU - Hara, Yoshitaka

AU - Kawaji, Takahiro

AU - Moriyama, Kazuhiro

AU - Shimomura, Yasuyo

AU - Niimi, Daisuke

AU - Komura, Hidefumi

AU - Nishida, Osamu

PY - 2019/6/24

Y1 - 2019/6/24

N2 - Background: We examined whether high lactate level in septic patients was associated with 90-day mortality based on the patients' disseminated intravascular coagulation (DIC) status. Methods: We conducted a multicenter, retrospective, observational study of patients admitted to the intensive care unit (ICU) with a suspicion of severe infection and diagnosed with sepsis. Regression analyses were performed to estimate the interaction effect between DIC status and the lactate level. Then, the association between the lactate level and 90-day mortality was assessed in the DIC and non-DIC subgroups. Results: The data of 415 patients were analyzed. We found a significant interaction between DIC status and the lactate level for predicting 90-day mortality (p interaction = 0.04). Therefore, we performed a subgroup analysis and found that high lactate concentration was significantly associated with 90-day mortality in the DIC group (odds ratio = 2.31, p = 0.039) but not in the non-DIC group. Conclusions: In patients with DIC, a high lactate level significantly predicted 90-day mortality; no such association was found in the non-DIC group. Thus, DIC status may serve as a possible effect modifier of lactate level in predicting mortality in patients with sepsis.

AB - Background: We examined whether high lactate level in septic patients was associated with 90-day mortality based on the patients' disseminated intravascular coagulation (DIC) status. Methods: We conducted a multicenter, retrospective, observational study of patients admitted to the intensive care unit (ICU) with a suspicion of severe infection and diagnosed with sepsis. Regression analyses were performed to estimate the interaction effect between DIC status and the lactate level. Then, the association between the lactate level and 90-day mortality was assessed in the DIC and non-DIC subgroups. Results: The data of 415 patients were analyzed. We found a significant interaction between DIC status and the lactate level for predicting 90-day mortality (p interaction = 0.04). Therefore, we performed a subgroup analysis and found that high lactate concentration was significantly associated with 90-day mortality in the DIC group (odds ratio = 2.31, p = 0.039) but not in the non-DIC group. Conclusions: In patients with DIC, a high lactate level significantly predicted 90-day mortality; no such association was found in the non-DIC group. Thus, DIC status may serve as a possible effect modifier of lactate level in predicting mortality in patients with sepsis.

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