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Clinical significance of lactate clearance in patients with cardiogenic shock: results from the RESCUE registry
- Title
- Clinical significance of lactate clearance in patients with cardiogenic shock: results from the RESCUE registry
- Authors
- Park, Ik Hyun; Yang, Jeong Hoon; Jang, Woo Jin; Chun, Woo Jung; Oh, Ju Hyeon; Park, Yong Hwan; Ko, Young-Guk; Yu, Cheol Woong; Kim, Bum Sung; Kim, Hyun-Joong; Lee, Hyun Jong; Jeong, Jin-Ok; Gwon, Hyeon-Cheol
- Ewha Authors
- 장우진
- SCOPUS Author ID
- 장우진
- Issue Date
- 2021
- Journal Title
- JOURNAL OF INTENSIVE CARE
- ISSN
- 2052-0492
- Citation
- JOURNAL OF INTENSIVE CARE vol. 9, no. 1
- Keywords
- Cardiogenic shock; Lactate clearance; Prognosis
- Publisher
- BMC
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background: Limited data are available on the clinical significance of lactate clearance (LC) in patients with cardiogenic shock (CS). This study investigated the prognostic role of LC in CS patients. Methods: We analyzed data from 628 patients in the RESCUE registry, a multicenter, observational cohort enrolled between January 2014 and December 2018. Univariable logistic regression analysis was performed to determine the prognostic implications of 24 h LC, and then patients were divided into two groups according to the cut-off value of 24 h LC (high lactate clearance [HLC] group vs. low lactate clearance [LLC] group). The primary outcome was in-hospital mortality. We also assessed all-cause mortality at 12 month follow-up and compared the prognostic performance of 24 h LC according to initial serum lactate level. Results: In the univariable logistic regression analysis, 24 h LC was associated with in-hospital mortality (odds ratio 0.989, 95% confidence interval [CI] 0.985-0.993, p < 0.001), and the cut-off value for the LC of the study population was 64%. The HLC group (initial 24 h LC >= 64%, n = 333) had a significantly lower incidence of in-hospital death than the LLC group (n = 295) (25.5% in the HLC group vs. 42.7% in the LLC group, p < 0.001). During 12 months of follow-up, the cumulative incidence of all-cause death was significantly lower in the HLC group than in the LLC group (33.0% vs. 48.8%; hazard ratio 0.55; 95% CI 0.42-0.70; p < 0.001). In subgroup analysis, 24 h LC predicted in-hospital mortality better in patients with initial serum lactate > 5 mmol/L than in those with serum lactate <= 5 mmol/L (c-statistics of initial serum lactate > 5 mmol/L = 0.782 vs. c-statistics of initial serum lactate <= 5 mmol/L = 0.660, p = 0.011). Conclusions: Higher LC during the early phase of CS was associated with reduced risk of in-hospital and 12 month all-cause mortalities. Patients with LC >= 64% during the 24 h after CS onset could expect a favorable prognosis, especially those with an initial serum lactate > 5 mmol/L.
- DOI
- 10.1186/s40560-021-00571-7
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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