Lactate normalization within 6 hours of bundle therapy and 24 hours of delayed achievement were associated with 28-day mortality in septic shock patients.
This study evaluated the prognostic ability of lactate normalization achieved within 6 and 24 h from septic shock recognition. Data from a septic shock registry from October 2015 to February 2017 were reviewed. The study included 2,102 eligible septic shock patients to analyze the prognostic ability...
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Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0217857 |
| _version_ | 1818986452707442688 |
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| author | Seung Mok Ryoo Ryeok Ahn Tae Gun Shin You Hwan Jo Sung Phil Chung Jin Ho Beom Sung-Hyuk Choi Young-Hoon Yoon Byuk Sung Ko Hui Jai Lee Gil Joon Suh Won Young Kim Korean Shock Society (KoSS) Investigators |
| author_facet | Seung Mok Ryoo Ryeok Ahn Tae Gun Shin You Hwan Jo Sung Phil Chung Jin Ho Beom Sung-Hyuk Choi Young-Hoon Yoon Byuk Sung Ko Hui Jai Lee Gil Joon Suh Won Young Kim Korean Shock Society (KoSS) Investigators |
| author_sort | Seung Mok Ryoo |
| collection | DOAJ |
| description | This study evaluated the prognostic ability of lactate normalization achieved within 6 and 24 h from septic shock recognition. Data from a septic shock registry from October 2015 to February 2017 were reviewed. The study included 2,102 eligible septic shock patients to analyze the prognostic ability of lactate normalization, defined as a follow-up lactate level <2 mmol/L within six hours of bundle therapy and within 24 hours of delayed normalization. The primary outcome was 28-day mortality. The overall 28-day mortality rate was 21.4%. The rates of lactate normalization within 6 and 24 h were significantly higher in the survivor groups than in the non-survivor group (42.4% vs. 23.4% and 60.2% vs. 31.2%; P<0.001, respectively). Multivariate logistic regression analysis showed that both 6- and 24-h lactate normalization were independent predictors (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.45-0.75, p<0.001 and OR 0.42, 95% CI 0.33-0.54, p<0.001, respectively). When we could not achieve the lactate normalization, the sensitivity, specificity, positive, and negative predictive value to predict mortality were 76.6%, 42.4%, 26.5% and 87.0% respectively for 6-h normalization, and 68.8%, 60.2%, 32.0% and 87.7% respectively for 24-h normalization. Besides 6-h lactate normalization, 24-h delayed lactate normalization was associated with decreasing mortality in septic shock patients. Lactate normalization may have a role in early risk stratification and as a therapeutic target. |
| first_indexed | 2024-12-20T18:51:01Z |
| format | Article |
| id | doaj.art-65038459039d40328518b79659ff45e8 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-20T18:51:01Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-65038459039d40328518b79659ff45e82022-12-21T19:29:35ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01146e021785710.1371/journal.pone.0217857Lactate normalization within 6 hours of bundle therapy and 24 hours of delayed achievement were associated with 28-day mortality in septic shock patients.Seung Mok RyooRyeok AhnTae Gun ShinYou Hwan JoSung Phil ChungJin Ho BeomSung-Hyuk ChoiYoung-Hoon YoonByuk Sung KoHui Jai LeeGil Joon SuhWon Young KimKorean Shock Society (KoSS) InvestigatorsThis study evaluated the prognostic ability of lactate normalization achieved within 6 and 24 h from septic shock recognition. Data from a septic shock registry from October 2015 to February 2017 were reviewed. The study included 2,102 eligible septic shock patients to analyze the prognostic ability of lactate normalization, defined as a follow-up lactate level <2 mmol/L within six hours of bundle therapy and within 24 hours of delayed normalization. The primary outcome was 28-day mortality. The overall 28-day mortality rate was 21.4%. The rates of lactate normalization within 6 and 24 h were significantly higher in the survivor groups than in the non-survivor group (42.4% vs. 23.4% and 60.2% vs. 31.2%; P<0.001, respectively). Multivariate logistic regression analysis showed that both 6- and 24-h lactate normalization were independent predictors (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.45-0.75, p<0.001 and OR 0.42, 95% CI 0.33-0.54, p<0.001, respectively). When we could not achieve the lactate normalization, the sensitivity, specificity, positive, and negative predictive value to predict mortality were 76.6%, 42.4%, 26.5% and 87.0% respectively for 6-h normalization, and 68.8%, 60.2%, 32.0% and 87.7% respectively for 24-h normalization. Besides 6-h lactate normalization, 24-h delayed lactate normalization was associated with decreasing mortality in septic shock patients. Lactate normalization may have a role in early risk stratification and as a therapeutic target.https://doi.org/10.1371/journal.pone.0217857 |
| spellingShingle | Seung Mok Ryoo Ryeok Ahn Tae Gun Shin You Hwan Jo Sung Phil Chung Jin Ho Beom Sung-Hyuk Choi Young-Hoon Yoon Byuk Sung Ko Hui Jai Lee Gil Joon Suh Won Young Kim Korean Shock Society (KoSS) Investigators Lactate normalization within 6 hours of bundle therapy and 24 hours of delayed achievement were associated with 28-day mortality in septic shock patients. PLoS ONE |
| title | Lactate normalization within 6 hours of bundle therapy and 24 hours of delayed achievement were associated with 28-day mortality in septic shock patients. |
| title_full | Lactate normalization within 6 hours of bundle therapy and 24 hours of delayed achievement were associated with 28-day mortality in septic shock patients. |
| title_fullStr | Lactate normalization within 6 hours of bundle therapy and 24 hours of delayed achievement were associated with 28-day mortality in septic shock patients. |
| title_full_unstemmed | Lactate normalization within 6 hours of bundle therapy and 24 hours of delayed achievement were associated with 28-day mortality in septic shock patients. |
| title_short | Lactate normalization within 6 hours of bundle therapy and 24 hours of delayed achievement were associated with 28-day mortality in septic shock patients. |
| title_sort | lactate normalization within 6 hours of bundle therapy and 24 hours of delayed achievement were associated with 28 day mortality in septic shock patients |
| url | https://doi.org/10.1371/journal.pone.0217857 |
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