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Lactate is associated with mortality in very old intensive care patients suffering from COVID-19: results from an international observational study of 2860 patients.

Overview of attention for article published in Annals of Intensive Care, August 2021
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (83rd percentile)

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17 tweeters

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Title
Lactate is associated with mortality in very old intensive care patients suffering from COVID-19: results from an international observational study of 2860 patients.
Published in
Annals of Intensive Care, August 2021
DOI 10.1186/s13613-021-00911-8
Pubmed ID
Authors

Bruno, Raphael Romano, Wernly, Bernhard, Flaatten, Hans, Fjølner, Jesper, Artigas, Antonio, Bollen Pinto, Bernardo, Schefold, Joerg C, Binnebössel, Stephan, Baldia, Philipp Heinrich, Kelm, Malte, Beil, Michael, Sigal, Sivri, van Heerden, Peter Vernon, Szczeklik, Wojciech, Elhadi, Muhammed, Joannidis, Michael, Oeyen, Sandra, Zafeiridis, Tilemachos, Wollborn, Jakob, Arche Banzo, Maria José, Fuest, Kristina, Marsh, Brian, Andersen, Finn H, Moreno, Rui, Leaver, Susannah, Boumendil, Ariane, De Lange, Dylan W, Guidet, Bertrand, Jung, Christian, , , Bruno RR, Wernly B, Flaatten H, Fjølner J, Artigas A, Bollen Pinto B, Schefold JC, Binnebössel S, Baldia PH, Kelm M, Beil M, Sigal S, van Heerden PV, Szczeklik W, Elhadi M, Joannidis M, Oeyen S, Zafeiridis T, Wollborn J, Arche Banzo MJ, Fuest K, Marsh B, Andersen FH, Moreno R, Leaver S, Boumendil A, De Lange DW, Guidet B, Jung C, undefined, Schefold, Joerg C., Andersen, Finn H., De Lange, Dylan W.

Abstract

Lactate is an established prognosticator in critical care. However, there still is insufficient evidence about its role in predicting outcome in COVID-19. This is of particular concern in older patients who have been mostly affected during the initial surge in 2020. This prospective international observation study (The COVIP study) recruited patients aged 70 years or older (ClinicalTrials.gov ID: NCT04321265) admitted to an intensive care unit (ICU) with COVID-19 disease from March 2020 to February 2021. In addition to serial lactate values (arterial blood gas analysis), we recorded several parameters, including SOFA score, ICU procedures, limitation of care, ICU- and 3-month mortality. A lactate concentration ≥ 2.0 mmol/L on the day of ICU admission (baseline) was defined as abnormal. The primary outcome was ICU-mortality. The secondary outcomes 30-day and 3-month mortality. In total, data from 2860 patients were analyzed. In most patients (68%), serum lactate was lower than 2 mmol/L. Elevated baseline serum lactate was associated with significantly higher ICU- and 3-month mortality (53% vs. 43%, and 71% vs. 57%, respectively, p < 0.001). In the multivariable analysis, the maximum lactate concentration on day 1 was independently associated with ICU mortality (aOR 1.06 95% CI 1.02-1.11; p = 0.007), 30-day mortality (aOR 1.07 95% CI 1.02-1.13; p = 0.005) and 3-month mortality (aOR 1.15 95% CI 1.08-1.24; p < 0.001) after adjustment for age, gender, SOFA score, and frailty. In 826 patients with baseline lactate ≥ 2 mmol/L sufficient data to calculate the difference between maximal levels on days 1 and 2 (∆ serum lactate) were available. A decreasing lactate concentration over time was inversely associated with ICU mortality after multivariate adjustment for SOFA score, age, Clinical Frailty Scale, and gender (aOR 0.60 95% CI 0.42-0.85; p = 0.004). In critically ill old intensive care patients suffering from COVID-19, lactate and its kinetics are valuable tools for outcome prediction. NCT04321265.

Twitter Demographics

The data shown below were collected from the profiles of 17 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 14 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 14 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 4 29%
Researcher 3 21%
Librarian 2 14%
Student > Doctoral Student 1 7%
Professor > Associate Professor 1 7%
Other 1 7%
Unknown 2 14%
Readers by discipline Count As %
Medicine and Dentistry 2 14%
Biochemistry, Genetics and Molecular Biology 2 14%
Social Sciences 2 14%
Agricultural and Biological Sciences 1 7%
Nursing and Health Professions 1 7%
Other 3 21%
Unknown 3 21%

Attention Score in Context

This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 September 2021.
All research outputs
#2,379,941
of 19,044,106 outputs
Outputs from Annals of Intensive Care
#256
of 883 outputs
Outputs of similar age
#49,178
of 306,252 outputs
Outputs of similar age from Annals of Intensive Care
#1
of 1 outputs
Altmetric has tracked 19,044,106 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 883 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.5. This one has gotten more attention than average, scoring higher than 71% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 306,252 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 83% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them