@article{JTD2826,
author = {Zhongheng Zhang and Kun Chen and Hongying Ni and Haozhe Fan},
title = {Predictive value of lactate in unselected critically ill patients: an analysis using fractional polynomials},
journal = {Journal of Thoracic Disease},
volume = {6},
number = {7},
year = {2014},
keywords = {},
abstract = {Background and objectives: Hyperlactatemia has long been associated with poor clinical outcome in varieties of intensive care unit (ICU) patients. However, the impact of temporal changes in lactate has not been well established and there are some shortcomings in model building in previous studies. The present study aims to investigate the association of initial lactate and normalization time with hazard by using fractional polynomial Cox proportional hazard model.
Methods: A large clinical database named Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC-II) was employed for analysis. Demographics, comorbidities, laboratory findings were extracted and were compared between survivors and non-survivors by using univariable analysis. Cox proportional hazard model was built by purposeful selection of covariate with initial lactate (L0) and normalization time (T) remaining in the model. Best fit model was selected by using deviance difference test and comparisons between fractional polynomial regression models of different degrees were performed by using closed test procedure.
Main results: A total of 6,291 ICU patients were identified to be eligible for the present study, including 1,675 non-survivors and 4,616 survivors (mortality rate: 26.6%). Patients with lactate normalization had significantly reduced hazard rate as compared to those without normalization (log-rank test: P},
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/2826}
}