The Association Between Tachycardia and Mortality in Septic Shock Patients According to Serum Lactate Level: A Nationwide Multicenter Cohort Study.

BACKGROUND

This study aimed to evaluate whether the effect of tachycardia varies according to the degree of tissue perfusion in septic shock.

METHODS

Patients with septic shock admitted to the intensive care units were categorized into the tachycardia (heart rate > 100 beats/min) and non-tachycardia (≤ 100 beats/min) groups. The association of tachycardia with hospital mortality was evaluated in each subgroup with low and high lactate levels, which were identified through a subpopulation treatment effect pattern plot analysis.

RESULTS

In overall patients, hospital mortality did not differ between the two groups (44.6% vs. 41.8%, = 0.441), however, tachycardia was associated with reduced hospital mortality rates in patients with a lactate level ≥ 5.3 mmol/L (48.7% vs. 60.3%, = 0.030; adjusted odds ratio [OR], 0.59, 95% confidence interval [CI], 0.35-0.99, = 0.045), not in patients with a lactate level < 5.3 mmol/L (36.5% vs. 29.7%, = 0.156; adjusted OR, 1.39, 95% CI, 0.82-2.35, = 0.227).

CONCLUSION

In septic shock patients, the effect of tachycardia on hospital mortality differed by serum lactate level. Tachycardia was associated with better survival in patients with significantly elevated lactate levels.