Cumulative lactate load correlates with cumulative Sequential Organ Failure Assessment score and survival in intensive care unit patients
Bibliographic record
Abstract
Changes in lactate levels are used as a prognostic marker in critically ill patients. However, the relation between the time course of arterial blood lactate clearance and important outcome parameters such as ICU length of stay (LOS), incidence of organ failure and survival rate has not been established. Case records from all ICU patients admitted between 2002 and 2004 were retrospectively identified in the ICU database. The Sequential Organ Failure Assessment (SOFA) score was calculated daily to assess the time course of organ failure. All lactate levels were extracted and the total cumulative lactate load (area under the curve above the upper normal level of 2.2 mmol/l; cum-lactate), and total cumulative SOFA score (cum-SOFA) were calculated and related to ICU LOS and final hospital survival. Values are the median (interquartile range). Observations in 1,711 ICU admissions were analyzed, age was 69 (57–77) years, cum-lactate was 420 (94–419 min· mmol/l) and cum-SOFA was 11 (4–38). Cum-SOFA was higher in patients with hyperlactatemia (cum-lactate > 0) during the ICU stay ( n = 782; 24 (7–71)) than in those without (5 (3–20); P < 0.001). Cum-SOFA correlated with cum-lactate and with ICU LOS, and cum-lactate correlated with ICU LOS (all P < 0.001). In patients who died in the hospital ( n = 329), cum-lactate (1,180 (203–3,427) min· mmol/l) and cum-SOFA (30 (10–95)) were higher than in hospital survivors ( n = 1,382; 298 (73–1,154) min· mmol/l, and 22 (5–67); both P < 0.001). In emergency admissions, cum-lactate (484 (113–2,031)) and cum-SOFA (27 (8–78)) were higher than in planned admissions (131 (37–454)) and (4 (3–28); both P < 0.001), respectively. In ICU patients, the cumulative area under the lactate curve correlates with the ICU LOS, cumulative SOFA score, and inhospital mortality. The prognostic value of cum-lactate requires prospective evaluation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".