Influence of Lactate on Prognostic Value of Patients with Septic Shock

Abstract

The latest time for lactate measurement in patients with septic shock in the intensive care unit (ICU) is still controversial, and there is little mention of the significant impact of lactate levels on patient mortality. This study aims to use statistical methods to analyze and predict the prognosis of patients with septic shock using lactate measurement values. All data comes from the eICU collaborative research database. This study first used statistical methods to describe the baseline characteristics of patients. Then, the optimal judgment threshold for lactate measurement was determined using the Jordan index, and patients were divided into two groups based on the optimal threshold. Based on this, survival analysis was conducted using the Kaplan Meier curve and the binary values of lactate levels, while conducting a multivariate analysis. Finally, the relationship between the latest measurement time of lactate and outcome was found through smooth curve fitting. The main exposed factor is lactate measurement, and the main outcome is 28 days mortality. The study included 5776 eligible patients with septic shock, including 4920 surviving patients and 856 deceased patients. Observations have confirmed that patients with severe sepsis or septic shock whose lactate value exceeds 2.29 mmol/L after entering the ICU have an increased risk of death. At the same time, the latest lactate measurement time after entering the ICU is 0.42 days, which is about 10 hours before entering the ICU ward; otherwise, it will endanger the patient's life.