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Title: | Associations between Late Lactate Clearance and Clinical Outcomes in Adults with Hyperlactataemia in the Setting of Diabetic Ketoacidosis | Authors: | Kumar, Aashish Anstey, Christopher Doola, Ra'eesa McIlroy, Philippa Whebell, Stephen Shekar, Kiran Attokaran, Antony Marella, Prashanti White, Kyle Luke, Stephen Tabah, Alexis Laupland, Kevin Ramanan, Mahesh |
Issue Date: | 2-Jan-2024 | Source: | Kumar A, Anstey C, Doola R, Mcllroy P, Whebell S, Shekar K, Attokaran A, Marella P, White K, Luke S, Tabah A, Laupland K, Ramanan M; Queensland Critical Care Research Network (QCCRN). Associations between Late Lactate Clearance and Clinical Outcomes in Adults with Hyperlactataemia in the Setting of Diabetic Ketoacidosis. J Clin Med. 2024 Aug 21;13(16):4933. doi: 10.3390/jcm13164933. PMID: 39201074; PMCID: PMC11355077. | Journal Title: | Journal of clinical medicine | Journal: | Journal of Clinical Medicine | Abstract: | Objective: This study aimed to determine the associations between lactate clearance in hyperlactataemic patients with diabetic ketoacidosis (DKA) and intensive care unit (ICU), hospital length of stay (LOS), and case-fatality. Methods: A retrospective, multicentre, cohort study of adult patients admitted to ICU with hyperlactataemia and a primary diagnosis of DKA from twelve sites in Queensland, Australia was conducted utilising pre-existing datasets that were linked for research purposes. The patients were divided into early and late lactate clearance groups; the early lactate clearance group included patients whose lactate returned to <2.0 mmol/L within 12 h, and the remainder were classified as late lactate clearance group. Results: The final dataset included 511 patients, 427 in the early lactate clearance group and 84 in the late lactate clearance group. Late lactate clearance was associated with increasing ICU LOS (β = +15.82, 95% CI +0.05 to +31.59, p < 0.049), increasing hospital LOS (β = +7.24, 95% CI +0.11 to 14.37, p = 0.048) and increasing Acute Physiology and Chronic Health Evaluation(APACHE) III score (ICU LOS outcome variable β = +1.05, 95% CI +0.88 to +1.22, p < 0.001; hospital LOS outcome variable β = +3.40, 95% CI +2.22 to 4.57, p < 0.001). Hospital case-fatality was not significantly different (2.2% in the early clearance group vs. 1.7% in the late clearance group, p = 0.496). Conclusions: In hyperlactataemic patients with DKA, late lactate clearance was associated with a statistically significant increase in both ICU and hospital LOS, though the clinical significance in both is minor. | Description: | Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated author: Philippa McIlroy | DOI: | 10.3390/jcm13164933 | Keywords: | diabetic ketoacidosis;lactate;critical care;diabetes | Type: | Article |
Appears in Sites: | Cairns & Hinterland HHS Publications |
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Associations between late lactate clearance and clinical outcomes in adults with hyperlactataemia.pdf | 1.76 MB | Adobe PDF | View/Open |
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