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Cited 6 time in webofscience Cited 8 time in scopus
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Lactate normalization within 6 hours of bundle therapy and 24 hours of delayed achievement were associated with 28-day mortality in septic shock patientsopen access

Authors
Ryoo, Seung MokAhn, RyeokShin, Tae GunJo, You HwanChung, Sung PhilBeom, Jin HoChoi, Sung-HyukYoon, Young-HoonKo, Byuk SungLee, Hui JaiSuh, Gil JoonKim, Won YoungPark, Yoo SeokKim, KyuseokShin, Jong HwanLee, Sung WooKang, Gu HyunLim, Tae HoChoi, Han Sung
Issue Date
Jun-2019
Publisher
Public Library of Science
Citation
PLoS ONE, v.14, no.6
Indexed
SCIE
SCOPUS
Journal Title
PLoS ONE
Volume
14
Number
6
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/1935
DOI
10.1371/journal.pone.0217857
ISSN
1932-6203
Abstract
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.
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Choi, Sung Hyuk
Guro Hospital (Department of Emergency Medicine, Guro Hospital)
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