The following is a summary of “Association of admission lactate with mortality in adult patients with severe community-acquired pneumonia,” published in the March 2023 issue of Emergency Medicine by Huang, et al.
For a study, researchers sought to determine whether admission lactate was related to death in patients with severe community-acquired pneumonia (SCAP).
Between December 2011 and December 2018, they conducted a retrospective, observational cohort study on adult SCAP patients hospitalized in the intensive care unit (ICU) at West China Hospital of Sichuan University. Mortality in hospitals was the main result. To find independent risk factors for hospital mortality, first, a univariate analysis was done, and then a multivariate analysis. Three logistic regression models and Kaplan-Meier graphs were used to investigate the relationship between hospital mortality and admission lactate classifications. To estimate the probable non-linear relationships, they additionally used restricted cubic splines.
There were 2,275 SCAP patients included in all. After multivariate regression, admission lactate was still a significant predictor of death (OR: 1.085; 95% CI: 1.033,1.141; by a continuous variable). Following the division of lactate into quartiles and complete adjustment of the covariates, the ORs (95% CIs) of hospital mortality for quartiles 2, 3, and 4 compared to quartile 1 were 1.001 (0.759-1.321), 1.153 (0.877-1.516), and 1.593 (1.202-2.109), respectively (P for trend =0.001). According to survival curves, high lactate levels were related to a bad prognosis (P< 0.001). Furthermore, because of the non-linear nature of the association, it may be concluded that mortality was most significantly impacted by increasing lactate between 1.5 and 4 mmol/L. (P non-linear: 0.029 for hospital mortality; 0.004 for ICU mortality).
Increased mortality in SCAP patients was significantly, independently, and maybe nonlinearly correlated with elevated admission lactate.