NGHIÊN CỨU GIÁ TRỊ CỦA ĐỘ THANH THẢI LACTATE MÁU TRONG TIÊN LƯỢNG TỬ VONG Ở BỆNH NHÂN SỐC NHIỄM KHUẨN

Abstract

Objective: To investigate the value of lactate clearance in predicting mortality in patients with septic shock. Method: septic shock was diagnosed according to sepsis 3-2016, lactate was quantified at the time of admission, 12 hours and 24 hours later and monitored until stable discharge or death. Lactate clearance was calculated according to the formula: lactate clearance = (initial blood lactate - blood lactate at the time of survey) x 100% / initial blood lactate. Compare lactate clearance between the 2 groups of survival and death, draw ROC curve, calculate area under the curve in predicting mortality. Results: 92 patients met the criteria to participate in the study, the mortality rate in patients with septic shock was 52.2%. Mean blood lactate at admission, 12 hours and 24 hours were 4.8 ± 3.4 mmol/l; 3.9 ± 2.9 mmol/l and 3.0 ± 2.9 mmol/l, respectively. Lactate clearance at 12 hours and 24 hours was 10.1 ± 5.6% and 5.1 ± 11.4%, respectively. Lactate clearance in the survival group was statistically significantly higher than in the death group, p < 0.05. Lactate clearance at 12 and 24 hours after admission was valuable in predicting mortality, corresponding to an area under the curve of 0.64 (cut off 17.8, sensitivity 62.5%, specificity 69.4%) and 0.77 (cut off 15.6, sensitivity 79.2%, specificity 61.1%), p < 0.05. Conclusion: Lactate clearance at 12 and 24 hours after admission was valuable in predicting mortality in patients with septic shock.