Lactate is associated with mortality in very old intensive care patients suffering from COVID-19: results from an international observational study of 2860 patients.
Détails
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_BE22F6A35E0E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Lactate is associated with mortality in very old intensive care patients suffering from COVID-19: results from an international observational study of 2860 patients.
Périodique
Annals of intensive care
Collaborateur⸱rice⸱s
COVIP Study Group
Contributeur⸱rice⸱s
Eller P., Joannidis M., Mesotten D., Reper P., Oeyen S., Swinnen W., Serck N., Dewaele E., Chapeta E., Brix H., Brushoej J., Kumar P., Nedergaard H.K., Johnsen T.K., Bundesen C., Hansen M.A., Uhrenholt S., Bundgaard H., Fjølner J., Innes R., Gooch J., Cagova L., Potter E., Reay M., Davey M., Abusayed M.A., Humphreys S., Collins A., Aujayeb A., Leaver S., Khaliq W., Habib A.A., Azab M.A., Wassim K., Elgazzar Y.A., Salah R., Abosheaishaa H.M., Hussein Mohamed AAR, Azzam A.Y., Tharwat S., Ali YKNM, Elmandouh O., Galal I., Abu-Elfatth A., Motawea K., Elbahnasawy M., Shehata M., Elbahnasawy M., Tayeb M., Osman N., Abdel-Elsalam W., Hussein A.M., Aldhalia A., Galbois A., Guidet B., Charron C., Berlemont C.H., Besch G., Rigaud J.P., Maizel J., Djibré M., Burtin P., Garcon P., Nseir S., Valette X., Alexandru N., Marin N., Vaissiere M., Plantefeve G., Mentec H., Vanderlinden T., Jurcisin I., Megarbane B., Chousterman B.G., Dépret F., Garnier M., Besset S., Oziel J., Ferre A., Dauger S., Dumas G., Goncalves B., Vettoretti L., Thevenin D., Schaller S., Kurt M., Faltlhauser A., Meyer C., Milovanovic M., Lutz M., Shala G., Haake H., Randerath W., Kunstein A., Meybohm P., Steiner S., Barth E., Poerner T., Simon P., Lorenz M., Dindane Z., Kuhn K.F., Welte M., Voigt I., Kabitz H.J., Wollborn J., Goebel U., Stoll S.E., Kindgen-Milles D., Dubler S., Jung C., Fuest K., Schuster M., Steiner S., Papadogoulas A., Mulita F., Rovina N., Aidoni Z., Chrisanthopoulou E., Kondili E., Andrianopoulos I., Gurjar M., Mahmoodpoor A., Hussein R., Al-Juaifari M.A., Karantenachy AKA, Sviri S., Elsaka A., Marsh B., Comellini V., Al-Ali F., Almani S., Khamees A.A., Al-Shami K., El Din I.S., Abubaker T., Ahmed H., Rabha A., Alhadi A., Emhamed M., Abdeewi S., Abusalama A., Alhadi A., Huwaysh M., Alghati E.A., Ghannam A., Namendys-Sylva S.A., Groenendijk M., Evers M., Van Lelyveld-Haas L., Meynaar I., Cornet A.D., Zegers M., Dieperink W., De Lange D., Dormans T., Hahn M., Sjøbøe B., Strietzel H.F., Olasveengen T., Romundstad L., Andersen F.H., Massoud JGG, Khan A.G., Al-Qasrawi S., Amro S., Kluzik A., Zatorski P., Drygalski T., Szczeklik W., Klimkiewicz J., Solek-Pastuszka J., Onichimowski D., Czuczwar M., Gawda R., Stefaniak J., Stefanska-Wronka K., Zabul E., Oliveira AIP, Assis R., De Lurdes Campos Santos M., Santos H., Cardoso F.S., Gordinho A., Grintescu I.M., Tomescu D., Badawy M.R., José Arche Banzo M., Zalba-Etayo B., Cubero P.J., Priego J., Gomà G., Tomasa-Irriguible T.M., Sancho S., Ferreira A.F., Vázquez E.M., Mira Á.P., Ibarz M., Iglesias D., Arias-Rivera S., Frutos-Vivar F., Lopez-Cuenca S., Aldecoa C., Perez-Torres D., Canas-Perez I., Tamayo-Lomas L., Diaz-Rodriguez C., De Gopegui P.R., Saleh M., Hilles MMY, Abualqumboz EMY, Ben-Hamouda N., Roberti A., Fleury Y., Abidi N., Schefold J.C., Chau I., Dullenkopf A., Chaaban M.K., Shebani M.M., Hmaideh A., Shaher A., Sahin A.S., Saracoglu K.T., Al-Sadawi M., Pugh R., Smuts S., Al-Saban RAM
ISSN
2110-5820 (Print)
ISSN-L
2110-5820
Statut éditorial
Publié
Date de publication
21/08/2021
Peer-reviewed
Oui
Volume
11
Numéro
1
Pages
128
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Résumé
Lactate is an established prognosticator in critical care. However, there still is insufficient evidence about its role in predicting outcome in COVID-19. This is of particular concern in older patients who have been mostly affected during the initial surge in 2020.
This prospective international observation study (The COVIP study) recruited patients aged 70 years or older (ClinicalTrials.gov ID: NCT04321265) admitted to an intensive care unit (ICU) with COVID-19 disease from March 2020 to February 2021. In addition to serial lactate values (arterial blood gas analysis), we recorded several parameters, including SOFA score, ICU procedures, limitation of care, ICU- and 3-month mortality. A lactate concentration ≥ 2.0 mmol/L on the day of ICU admission (baseline) was defined as abnormal. The primary outcome was ICU-mortality. The secondary outcomes 30-day and 3-month mortality.
In total, data from 2860 patients were analyzed. In most patients (68%), serum lactate was lower than 2 mmol/L. Elevated baseline serum lactate was associated with significantly higher ICU- and 3-month mortality (53% vs. 43%, and 71% vs. 57%, respectively, p < 0.001). In the multivariable analysis, the maximum lactate concentration on day 1 was independently associated with ICU mortality (aOR 1.06 95% CI 1.02-1.11; p = 0.007), 30-day mortality (aOR 1.07 95% CI 1.02-1.13; p = 0.005) and 3-month mortality (aOR 1.15 95% CI 1.08-1.24; p < 0.001) after adjustment for age, gender, SOFA score, and frailty. In 826 patients with baseline lactate ≥ 2 mmol/L sufficient data to calculate the difference between maximal levels on days 1 and 2 (∆ serum lactate) were available. A decreasing lactate concentration over time was inversely associated with ICU mortality after multivariate adjustment for SOFA score, age, Clinical Frailty Scale, and gender (aOR 0.60 95% CI 0.42-0.85; p = 0.004).
In critically ill old intensive care patients suffering from COVID-19, lactate and its kinetics are valuable tools for outcome prediction.
NCT04321265.
This prospective international observation study (The COVIP study) recruited patients aged 70 years or older (ClinicalTrials.gov ID: NCT04321265) admitted to an intensive care unit (ICU) with COVID-19 disease from March 2020 to February 2021. In addition to serial lactate values (arterial blood gas analysis), we recorded several parameters, including SOFA score, ICU procedures, limitation of care, ICU- and 3-month mortality. A lactate concentration ≥ 2.0 mmol/L on the day of ICU admission (baseline) was defined as abnormal. The primary outcome was ICU-mortality. The secondary outcomes 30-day and 3-month mortality.
In total, data from 2860 patients were analyzed. In most patients (68%), serum lactate was lower than 2 mmol/L. Elevated baseline serum lactate was associated with significantly higher ICU- and 3-month mortality (53% vs. 43%, and 71% vs. 57%, respectively, p < 0.001). In the multivariable analysis, the maximum lactate concentration on day 1 was independently associated with ICU mortality (aOR 1.06 95% CI 1.02-1.11; p = 0.007), 30-day mortality (aOR 1.07 95% CI 1.02-1.13; p = 0.005) and 3-month mortality (aOR 1.15 95% CI 1.08-1.24; p < 0.001) after adjustment for age, gender, SOFA score, and frailty. In 826 patients with baseline lactate ≥ 2 mmol/L sufficient data to calculate the difference between maximal levels on days 1 and 2 (∆ serum lactate) were available. A decreasing lactate concentration over time was inversely associated with ICU mortality after multivariate adjustment for SOFA score, age, Clinical Frailty Scale, and gender (aOR 0.60 95% CI 0.42-0.85; p = 0.004).
In critically ill old intensive care patients suffering from COVID-19, lactate and its kinetics are valuable tools for outcome prediction.
NCT04321265.
Pubmed
Web of science
Création de la notice
03/03/2022 20:20
Dernière modification de la notice
23/11/2022 7:14
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