Emergency Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Chaoyang District, Beijing, 100029, China.
Centre of Hypertension, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
BMC Cardiovasc Disord. 2024 Jul 10;24(1):348. doi: 10.1186/s12872-024-04013-8.
Early prognosis evaluation is crucial for decision-making in cardiogenic shock (CS) patients. Dynamic lactate assessment, for example, normalized lactate load, has been a better prognosis predictor than single lactate value in septic shock. Our objective was to investigate the correlation between normalized lactate load and in-hospital mortality in patients with CS.
Data were extracted from the Medical Information Mart for Intensive Care (MIMIC)-IV database. The calculation of lactate load involved the determination of the cumulative area under the lactate curve, while normalized lactate load was computed by dividing the lactate load by the corresponding period. Receiver Operating Characteristic (ROC) curves were constructed, and the evaluation of areas under the curves (AUC) for various parameters was performed using the DeLong test.
Our study involved a cohort of 1932 CS patients, with 687 individuals (36.1%) experiencing mortality during their hospitalization. The AUC for normalized lactate load demonstrated significant superiority compared to the first lactate (0.675 vs. 0.646, P < 0.001), maximum lactate (0.675 vs. 0.651, P < 0.001), and mean lactate (0.675 vs. 0.669, P = 0.003). Notably, the AUC for normalized lactate load showed comparability to that of the Sequential Organ Failure Assessment (SOFA) score (0.675 vs. 0.695, P = 0.175).
The normalized lactate load was an independently associated with the in-hospital mortality among CS patients.
心源性休克（CS）患者的早期预后评估至关重要。例如，与单一乳酸值相比，动态乳酸评估，即乳酸负荷正常化，是更好的预后预测指标。我们的目的是研究 CS 患者中乳酸负荷正常化与院内死亡率之间的相关性。
从医疗信息监护 IV（MIMIC-IV）数据库中提取数据。乳酸负荷的计算涉及确定乳酸曲线下的累积面积，而乳酸负荷正常化则通过将乳酸负荷除以相应的时间段来计算。构建了接收者操作特征（ROC）曲线，并使用 DeLong 检验对各种参数的曲线下面积（AUC）进行了评估。
我们的研究涉及 1932 例 CS 患者，其中 687 例（36.1%）在住院期间死亡。与首次乳酸（0.646，P<0.001）、最大乳酸（0.651，P<0.001）和平均乳酸（0.669，P=0.003）相比，乳酸负荷正常化的 AUC 具有显著优势。值得注意的是，乳酸负荷正常化的 AUC 与序贯器官衰竭评估（SOFA）评分相当（0.675，P=0.175）。
乳酸负荷正常化与 CS 患者的院内死亡率独立相关。
