GIÁ TRỊ TIÊN LƯỢNG TỬ VONG CỦA LACTAT MÁU Ở NGƯỜI BỆNH SỐC NHIỄM KHUẨN ĐIỀU TRỊ TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI TRUNG ƯƠNG GIAI ĐOẠN 2018-2022

Abstract

A cross-sectional descriptive study on 134 septic shock patients treated at the National Hospital for Tropical Diseases from the year of 2018 to 2022 to evaluate the predictive value of blood lactate for mortality in septic shock. Results: The average blood lactate concentration at the septic shock was 5,5 ± 4,0 mmol/l, the highest at 24 hours after shock and gradually decreased at 48 and 72 hours after shock. At the time of septic shock and after shock, the mean lactate concentration of the deceased group was significantly higher than that of the surviving group. Blood lactate is a good predictor for mortality in patients with septic shock, with an area under the curve (AUC) of 0,703, p<0,001 (95%CI: 0,605 – 0,801). Analysis between deceased and surviving groups showed that, the cut-off point of blood lactate is 3,95 mmol/l (J = 0,367), sensitivity 65,6% and specificity 71,1%. Univariate logistic regression analysis showed that patients with lactate concentration ≥ 3,95 mmol/l had a 4,6 times higher risk of death than patients with lactate concentration < 3,95 mmol/l (p<0,001). Lactate levels at 48 hours after shock had the best predicting mortality compared with at septic shock and 24 hours after shock with AUC = 0,818, p = 0,000 (95%CI: 0,711 – 0,924). Conclusion: Blood lactate level at 48h after shock is a good predictor for mortality. Therefore, it is necessary to test blood lactate many time during septic shock, especially at 48 hours after shock for prognosticating patient.