Blood lactate level prediction of mortality in critically ill children in Latvia

Toms Dombrovskis, Ivars Vegeris, Reinis Balmaks

Research output: Contribution to conferenceAbstractpeer-review

Abstract

Paediatric Index of Mortality 2 (PIM2) is widely used for risk prediction of patients admitted to Paediatric Intensive Care Unit (PICU) based on clinical variables collected during the first hour of admission. Studies have shown that lactate is a useful biomarker for estimation of disease severity and mortality. The goal of this study was to investigate association between blood lactate level at the time of admission and mortality in Childrens Clinical University Hospital (VSIA BKUS PICU patient population. This retrospective observational study (RSU Ethics Committee 51/22.02.2018.) involved all patients who were admitted to VSIA BKUS PICU from 1 January, 2004 to 31 December, 2020 and had blood lactate level measured during the first hour of admission. The primary outcome of this study was considered mortality in PICU; the secondary outcome was lenght of stay in PICU. Bionomial logistic and multiple linear regressions were performed using IMB SPSS Software. P value less than 0.05 was considered significant. A total of 669 admissions were eligible for this study. 32 (4.8%) died during PICU admission. Blood lactate level was significantly increased in non-survivors (OR 3.7 (95% CI: 1.87-8.69)) compared to survivors (OR 1.81 (95% CI: 1.32-2.57)). Variables that statistically correlated with mortality (non-postoperative status, source of admission, no cardiopulmonary bypass, fixed areactive pupils, length of mechanical ventilation, systolic blood pressure, base excess, lactate, PIM2 score) were entered into the bionomial logic regression model. PIM2 score (OR 4.0 (95% CI: 1.71-1920.48)) and length of mechanical ventilation (days) (OR 0.09 (95% CI: 1.03-1.15) were independently associated with mortality. Blood lactate level was not predictive for length of stay. However, lactate level correlated well with PIM2 score (Pearson, r = 0.60, p = 0.01). PIM2 is a good risk stratification tool in VSIA BKUS PICU population. Blood lactate does not significantly improve its performance.
Original languageEnglish
Pages46
Publication statusPublished - 24 Mar 2021
EventRSU Research week 2021: Knowledge for Use in Practice - Rīga, Latvia
Duration: 24 Mar 202126 Mar 2021
https://rw2021.rsu.lv/conferences/knowledge-use-practice

Conference

ConferenceRSU Research week 2021: Knowledge for Use in Practice
Abbreviated titleRW2021
CountryLatvia
CityRīga
Period24/03/2126/03/21
Internet address

Field of Science

  • 3.2 Clinical medicine

Publication Type

  • 3.4. Other publications in conference proceedings (including local)

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