Early lactate trajectories predict mortality in sepsis-associated acute lung injury: A retrospective cohort study - 17/11/25
Abstract |
Background |
Sepsis-associated acute lung injury (SALI) is a life-threatening respiratory condition with high mortality. Serum lactate is a key marker of oxygen metabolism and tissue hypoperfusion. This study aimed to investigate whether dynamic lactate trajectories in the early ICU period could predict 28-day mortality in SALI patients.
Methods |
We retrospectively analyzed 340 patients with SALI from the MIMIC-IV database. Lactate trajectories over the first three ICU days were identified using latent growth mixture modeling (LGMM). Cox proportional hazards models and Kaplan–Meier survival analyses were used to evaluate the association between trajectory classes and 28-day mortality. The prognostic performance of SOFA score alone and in combination with lactate trajectory was compared using ROC curves.
Results |
Three distinct lactate trajectory classes were identified: persistently elevated, low and stable, and initially elevated then declining. Patients in the low-stable and moderate-declining groups had significantly lower mortality risks compared to those with persistently high lactate. Adding lactate trajectory to SOFA improved AUC from 0.629 to 0.693 (P = 0.0074).
Conclusion |
Early lactate trajectory classification is an independent predictor of mortality in SALI patients and enhances prognostic performance beyond SOFA. Incorporating trajectory-based risk stratification may inform more personalized respiratory management strategies.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | Three distinct lactate trajectories were identified in sepsis-associated acute lung injury. |
• | The persistently high-lactate group showed the highest 28-day mortality. |
• | Integrating lactate trajectories into SOFA improved prognostic performance (AUC 0.693). |
• | Decision curve analysis confirmed greater clinical net benefit of the combined model. |
• | Lactate trajectories provide a dynamic biomarker for individualized ICU risk assessment. |
Keywords : Sepsis-associated acute lung injury, Lactate trajectory, Intensive care unit, Mortality prediction, Latent class modeling, SOFA score
Mappa
Vol 249
Articolo 108471- novembre 2025 Ritorno al numero
Articolo precedente
- Comprehensive quantitation of bronchial and lung parenchymal lesions in idiopathic pleuroparenchymal fibroelastosis
- Atsushi Matsunashi, Tomoki Maetani, Tomohiro Handa, Kohei Ikezoe, Ryuji Uozumi, Naoya Tanabe, Ryo Sakamoto, Michihiro Uyama, Kiminobu Tanizawa, Toyohiro Hirai
- Plasma proteins associated with cardiovascular disease in relation to lung function in SCAPIS
- Suneela Zaigham, Per Liv, Elin Chorell, Annelie Behndig, Apostolos Bossios, Kenneth Caidahl, Anna-Carin Olin, Arne Egesten, Jan Engvall, Jonas Eriksson Ström, Andreas Frølich, Ludger Grote, Anders Gummesson, Viktor Hamrefors, Christer Janson, David Kylhammar, Eva Lindberg, Anders Lindén, Mirjam Ljunggren, Hans Lennart Persson, Magnus Sköld, Ellen Tufvesson, Lowie egw Vanfleteren, Andrei Malinovschi, Anders Blomberg
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?