"An Analysis of Lactate Measurement Patterns in Critical Care-Evidence " by Tanya Amal, R Nath et al.
 

An Analysis of Lactate Measurement Patterns in Critical Care-Evidence or Intuition?

Document Type

Conference Proceeding

Publication Date

5-2025

Publication Title

American Journal of Respiratory and Critical Care Medicine

Abstract

Introduction: Lactate measurement trends have increased over the last few decades. A study by Chanu et. Al) , showed an increase in lactate measurements from 11% (2003) to 48% (2013); associated with an increase in repeating lactate within the first 6 hours (during the “ebb” phase)- (23% to 69%). Despite this, lactate measurement has a low sensitivity (34%) and fails to detect around 35% of severe sepsis cases at onset . This may be explained by clinical reliance on certain prognostic scoring to purse lactate trends. Results: Patients who died had significantly higher measurement frequencies (mean 10.93 ± 12.72) compared to survivors (mean 6.63 ± 11.03). Logistic regression analysis revealed measurement frequency as an independent predictor of mortality (OR = 1.036, 95% CI: 1.031-1.041, p < 0.001), with each additional measurement associated with a 3.6% increase in mortality odds. Age was also significantly associated with mortality (OR = 1.019, 95% CI: 1.015-1.023, p < 0.001), while gender showed no significant effect (OR = 1.065, 95% CI: 0.955-1.187, p = 0.257). Analysis of racial/ethnic disparities revealed significant variations in measurement patterns, though most racial categories showed no independent association with mortality after controlling for other factors. Discussion: Our analysis showed increased testing frequency based on the SOFA score. This may be related to physician’s cognitive bias based on the clinical presentation. Increased lactate measurement frequency was associated with increased mortality, which may relate to severity of disease. However it also highlights further investigation to determine if lactate measuring frequency affects outcome. Our analysis also showed age and gender affecting mortality, further pointing towards possible effect of health care inequir=ty and clinical bias.

Volume

211

First Page

A3730

Comments

American Thoracic Society (ATS) International Conference, May 16-21, 2025, San Francisco, CA

Last Page

A3730

DOI

10.1164/ajrccm.2025.211.Abstracts.A3730

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