<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_jccm-2023-0005_s_006"><h3>Background</h3>
<p>Single lactate measurements have been reported to have prognostic significance, however, there is a lack of data in local literature from Pakistan. This study was done to determine prognostic role of lactate clearance in sepsis patients being managed in our lower-middle income country.</p></sec>
<sec id="j_jccm-2023-0005_s_007"><h3>Methods</h3>
<p>This prospective cohort study was conducted from September 2019-February 2020 at the Aga Khan University Hospital, Karachi. Patients were enrolled using consecutive sampling and categorized based on their lactate clearance status. Lactate clearance was defined as decrease by 10% or greater in repeat lactate from the initial measurement (or both initial and repeat levels &lt;=2.0 mmol/L).</p></sec>
<sec id="j_jccm-2023-0005_s_008"><h3>Results</h3>
<p>A total 198 patients were included in the study, 51% (101) were male. Multi-organ dysfunction was reported in 18.6% (37), 47.7% (94) had single organ dysfunction, and 33.8% (67) had no organ dysfunction. Around 83% (165) were discharged and 17% (33) died. There were missing data for 25.8% (51) of the patients for the lactate clearance, whereas 55% (108) patients had early lactate clearance and 19.7% (39) had delayed lactate clearance.On univariate analysis, mortality rate was higher in patients with delayed lactate clearance (38.4% vs 16.6%) and patients were 3.12 times (OR = 3.12; [95% CI: 1.37-7.09]) more likely to die as compared with early lactate clearance. Patients with delayed lactate clearance had higher organ dysfunction (79.4% vs 60.1%) and were 2.56 (OR = 2.56; [95% CI: 1.07-6.13]) times likely to have organ dysfunction. On multivariate analysis, after adjusting for age and co-morbids, patients with delayed lactate clearance were 8 times more likely to die than patients with early lactate clearance [aOR = 7.67; 95% CI:1.11-53.26], however, there was no statistically significant association between delayed lactate clearance [aOR = 2.18; 95% CI: 0.87-5.49)] and organ dysfunction.</p></sec>
<sec id="j_jccm-2023-0005_s_009"><h3>Conclusion</h3>
<p>Lactate clearance is a better determinant of sepsis and septic shock effective management. Early lactate clearance is related to better outcomes in septic patients.</p></sec>
</abstract>

Background
Single lactate measurements have been reported to have prognostic significance, however, there is a lack of data in local literature from Pakistan. This study was done to determine prognostic role of lactate clearance in sepsis patients being managed in our lower-middle income country.
Methods
This prospective cohort study was conducted from September 2019-February 2020 at the Aga Khan University Hospital, Karachi. Patients were enrolled using consecutive sampling and categorized based on their lactate clearance status. Lactate clearance was defined as decrease by 10% or greater in repeat lactate from the initial measurement (or both initial and repeat levels <=2.0 mmol/L).
Results
A total 198 patients were included in the study, 51% (101) were male. Multi-organ dysfunction was reported in 18.6% (37), 47.7% (94) had single organ dysfunction, and 33.8% (67) had no organ dysfunction. Around 83% (165) were discharged and 17% (33) died. There were missing data for 25.8% (51) of the patients for the lactate clearance, whereas 55% (108) patients had early lactate clearance and 19.7% (39) had delayed lactate clearance.On univariate analysis, mortality rate was higher in patients with delayed lactate clearance (38.4% vs 16.6%) and patients were 3.12 times (OR = 3.12; [95% CI: 1.37-7.09]) more likely to die as compared with early lactate clearance. Patients with delayed lactate clearance had higher organ dysfunction (79.4% vs 60.1%) and were 2.56 (OR = 2.56; [95% CI: 1.07-6.13]) times likely to have organ dysfunction. On multivariate analysis, after adjusting for age and co-morbids, patients with delayed lactate clearance were 8 times more likely to die than patients with early lactate clearance [aOR = 7.67; 95% CI:1.11-53.26], however, there was no statistically significant association between delayed lactate clearance [aOR = 2.18; 95% CI: 0.87-5.49)] and organ dysfunction.
Conclusion
Lactate clearance is a better determinant of sepsis and septic shock effective management. Early lactate clearance is related to better outcomes in septic patients.

Early Lactate Clearance as a Determinant of Survival in Patients with Sepsis: Findings from a Low-resource Country

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
Single lactate measurements have been reported to have prognostic significance, however, there is a lack of data in local literature from Pakistan....

Early Lactate Clearance as a Determinant of Survival in Patients with Sepsis: Findings from a Low-resource Country

Article Category: Research Article

Publié en ligne: 08 févr. 2023

Pages: 30 - 38

Reçu: 19 avr. 2022

Accepté: 14 janv. 2023

DOI: https://doi.org/10.2478/jccm-2023-0005

Mots clés
sepsis, mortality, lactate, outcomes

© 2023 Fazal Rehman, Saad Bin Zafar, Adil Aziz, Abdul Aziz, Pirbhat Shams Memon, Taymmia Ejaz, Summaira Aziz, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Early Lactate Clearance as a Determinant of Survival in Patients with Sepsis: Findings from a Low-resource Country

Article Category: Research Article

Publié en ligne: 08 févr. 2023

Pages: 30 - 38

Reçu: 19 avr. 2022

Accepté: 14 janv. 2023

DOI: https://doi.org/10.2478/jccm-2023-0005

Mots cléssepsis, mortality, lactate, outcomes

© 2023 Fazal Rehman, Saad Bin Zafar, Adil Aziz, Abdul Aziz, Pirbhat Shams Memon, Taymmia Ejaz, Summaira Aziz, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Mots clés
sepsis, mortality, lactate, outcomes