Association Between Early Lactate Levels and 30-Day Mortality in Clinically Suspected Sepsis in Children

Abstract

Objective:To determine the correlation between initial levels of lactate and 30-day mortality rate in suspicious cases of sepsis in pediatrics.

Methodology:  Study was prospective observational conducted upon 350 patients. The study was held among patients of pediatrics department of Nishtar hospital, Multan. Patients of sepsis were included in the study and were tested for the hypothesis that there is increased risk of mortality with serum lactate levels more than 36mg/dL rather than when levels are less than 36mg/dL. For this, different measurements were taken and compared at different levels of lactate among the patients with sepsis. SPSS version 24 was used to analyzed data and student t-test and chi-square test was applied to see association among variables. P value ≤ 0.05 was taken as significant.

Results: There were 60% (n=105) males and 40% (n=70) females. Comorbidity, oncologic, nononcologic, none and central line present was observed as 74.9% (n=131), 27.4% (n=48), 45.1% (n=79), 32.6% (n=57) and 23.4% (n=41) respectively. Organ dysfunction, hypotension, hematologic, hepatic and renal was noted as 27.4% (n=48), 14.9% (n=26), 17.7% (n=31), 0.6% (n=1) and 16% (n=28) respectively. While, the mean age, heart rate, systolic blood pressure, temperature and pulse oximetry of the 3-day hospital mortality patients was 8.11±4.03 years, 143.21±2.54 bpm, 109.12±3.68 mm Hg, 38.06±1.96 °C and 93.69±2.78 respectively. Conclusion: when serum level of lactate is more than 36mg/dL, high risk of mortality is present but with less senistivity. A record of initial levels of lactate may prove to be useful in initial risk detection in sepsis in pediatrics.

Keywords: Lactate, Mortality, Children, Sepsis