Neuroanesthesia & neurocritical care
Time-weighted lactate and glucose–lactate ratio outperform static values in ICU mortality prediction after traumatic brain injury: a retrospective cohort study
Authors' conclusion
In critically ill non-diabetic patients with TBI, longitudinal time-weighted average lactate significantly outperformed admission values and glucose metrics for predicting ICU mortality in a severity-balanced cohort; the glucose-lactate ratio was associated but did not surpass lactate.
Study context
- Population
- Non-diabetic adults with traumatic brain injury (TBI) admitted to a German university ICU (2013–2023)matched from 479
- Participants
- 229 adults
- Exposure
- Survivors vs Non-survivors
- Survivorsn = 150reference
- Non-survivorsn = 79
- Outcome
- ICU mortality
Methodological detailssingle-centre, 1:2 severity-balanced, outcome-stratified propensity-score matched
- Single-centre
- 1:2 severity-balanced, outcome-stratified propensity-score matched
Main finding
As reported in the abstract
Time-weighted average lactate: best independent predictor, OR
14.70
95% CI 5.41–39.98p < 0.001
Time-weighted average lactate AUC
0.73
Time-weighted average glucose-lactate ratio: independent predictor, OR
0.75
95% CI 0.66–0.86p < 0.001
Observational data: associations, not effects.
Further findings
Daily lactate, Non-survivors vs Survivors · first ten ICU days
- Non-survivors persistently higher glucose, lactate and lower ratios; lactate significantly elevated on all first ten ICU days
- all p < 0.05
Original publication
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