Table 4.
Performance of blood-based biomarkers in predicting outcomes.
| Markers | AUC (95% CI) | P value | SN | SP | PPV | NPV | LR+ | LR− | Youden Index | Accuracy | Cut-point |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Mortality (yes vs. no) | |||||||||||
| Lactate/albumin | 0.917 (0.861–0.956) | < 0.001* | 100 | 63 | 58 | 100 | 2.7 | 0 | 0.63 | 75.49 | > 0.1 |
| Lactate baseline | 0.527 (0.444–0.609) | 0.633 | 31.3 | 92.9 | 69.7 | 72.4 | 4.48 | 0.74 | 0.24 | 72.05 | > 4.2 |
| Lactate 6 h | 0.657 (0.576–0.733) | 0.002* | 41.18 | 89.9 | 68 | 75 | 4.08 | 0.65 | 0.31 | 73.40 | > 3.5 |
| Lactate 12 h | 0.779 (0.704–0.842) | < 0.001* | 66.67 | 83.84 | 68.22 | 83.1 | 4.7 | 0.40 | 0.50 | 78.11 | > 2.8 |
| Lactate 24 h | 0.904 (0.845–0.946) | < 0.001* | 84.31 | 85.86 | 75.6 | 91.4 | 6.02 | 0.18 | 0.70 | 85.43 | > 2.3 |
| Clearance lactate 6 h | 0.708 (0.627–0.780) | < 0.001* | 62.75 | 76 | 57.3 | 79.8 | 2.61 | 0.49 | 0.37 | 71.49 | ≤ 15.8 |
| Clearance lactate 12 h | 0.846 (0.776–0.900) | < 0.001* | 76.47 | 86 | 73.7 | 87.6 | 5.46 | 0.27 | 0.62 | 82.76 | ≤ 27.9 |
| Clearance lactate 24 h | 0.963 (0.918–0.987) | < 0.001* | 94.12 | 91 | 83.3 | 96.7 | 10.4 | 0.06 | 0.86 | 92.06 | ≤ 35.1 |
| RRT (yes vs. no) | |||||||||||
| Lactate/albumin | 0.703 (0.623–0.775) | < 0.001* | 82.86 | 49.14 | 32.9 | 90.5 | 1.63 | 0.35 | 0.32 | 56.95 | > 0.1 |
| Lactate baseline | 0.646 (0.563–0.722) | 0.016* | 62.86 | 63.48 | 34.18 | 84.9 | 1.72 | 0.59 | 0.28 | 63.33 | > 4 |
| Lactate 6 h | 0.645 (0.562–0.721) | 0.019* | 62.86 | 63.79 | 34.40 | 85.1 | 1.74 | 0.58 | 0.28 | 63.58 | > 3.2 |
| Lactate 12 h | 0.649 (0.567–0.725) | 0.007* | 55.88 | 75 | 39.61 | 84.4 | 2.17 | 0.61 | 0.31 | 70.19 | > 2.9 |
| Lactate 24 h | 0.696 (0.616–0.768) | 0.002* | 64.71 | 62.93 | 33.87 | 84.8 | 1.70 | 0.59 | 0.27 | 62.91 | > 2.2 |
| Clearance lactate 6 h | 0.597 (0.512–0.677) | 0.102 | 50.00 | 72.97 | 33.99 | 82.6 | 1.70 | 0.70 | 0.23 | 65.56 | ≤ 15.6 |
| Clearance lactate 12 h | 0.614 (0.529–0.693) | 0.025* | 85.29 | 44.14 | 31.25 | 90.6 | 1.48 | 0.34 | 0.29 | 52.44 | ≤ 34.4 |
| Clearance lactate 24 h | 0.671 (0.588–0.747) | 0.002* | 52.94 | 79.28 | 40.79 | 84.4 | 2.25 | 0.60 | 0.32 | 70.80 | ≤ 31.9 |
| ICU length of stay (≥ 11 days vs. < 11 days) | |||||||||||
| Lactate/Albumin | 0.709 (0.630–0.780) | < 0.001* | 76.92 | 61.64 | 68.19 | 71.4 | 2.01 | 0.37 | 0.38 | 69.54 | > 0.1 |
| Lactate baseline | 0.522 (0.439–0.604) | 0.644 | 85.90 | 1.39 | 48.56 | 15.3 | 0.88 | 5.15 | 0.12 | 45.70 | > 3.4 |
| Lactate 6 h | 0.569 (0.486–0.649) | 0.141 | 43.59 | 73.61 | 64.15 | 55.1 | 1.67 | 0.76 | 0.17 | 58.28 | > 3.3 |
| Lactate 12 h | 0.593 (0.510–0.672) | 0.046* | 43.59 | 77.78 | 68.00 | 56.4 | 1.99 | 0.72 | 0.21 | 60.26 | > 2.8 |
| Lactate 24 h | 0.675 (0.594–0.750) | < 0.001* | 52.56 | 77.78 | 71.97 | 60.6 | 2.40 | 0.61 | 0.30 | 64.89 | > 2.3 |
| Clearance lactate 6 h | 0.585 (0.500–0.666) | 0.074 | 42.47 | 73.61 | 64.33 | 55.7 | 1.68 | 0.74 | 0.16 | 58.93 | ≤ 15.8 |
| Clearance lactate 12 h | 0.625 (0.541–0.704) | 0.008* | 49.32 | 75.00 | 68.37 | 59.3 | 2.02 | 0.64 | 0.24 | 62.90 | ≤ 29.2 |
| Clearance lactate 24 h | 0.684 (0.602–0.759) | < 0.001* | 58.90 | 80.56 | 77.22 | 65.8 | 2.99 | 0.48 | 0.39 | 70.19 | ≤ 38.1 |
| Duration MV (≥ 6 days vs. < 6 days) | |||||||||||
| Lactate/Albumin | 0.754 (0.678–0.821) | < 0.001* | 71.03 | 72.73 | 86.36 | 50.7 | 2.60 | 0.4 | 0.43 | 71.52 | > 0.1 |
| Lactate baseline | 0.548 (0.465–0.629) | 0.318 | 47.17 | 68.18 | 78.28 | 34.6 | 1.48 | 0.77 | 0.15 | 53.29 | > 4 |
| Lactate 6 h | 0.602 (0.519–0.681) | 0.030* | 26.42 | 93.18 | 90.32 | 34.2 | 3.84 | 0.79 | 0.19 | 45.70 | > 3.5 |
| Lactate 12 h | 0.682 (0.601–0.755) | < 0.001* | 43.40 | 90.91 | 92.00 | 39.6 | 4.73 | 0.63 | 0.34 | 56.95 | > 2.8 |
| Lactate 24 h | 0.764 (0.687–0.829) | < 0.001* | 57.55 | 90.91 | 93.85 | 46.5 | 6.27 | 0.47 | 0.48 | 66.89 | > 2.2 |
| Clearance lactate 6 h | 0.606 (0.522–0.686) | 0.037* | 50.47 | 72.73 | 81.82 | 37.6 | 1.85 | 0.68 | 0.20 | 56.95 | ≤ 16.2 |
| Clearance lactate 12 h | 0.700 (0.618–0.773) | < 0.001* | 47.52 | 86.36 | 90.00 | 41.7 | 3.70 | 0.57 | 0.33 | 60.93 | ≤ 29.2 |
| Clearance lactate 24 h | 0.757 (0.679–0.824) | < 0.001* | 61.39 | 88.64 | 93.15 | 50.0 | 5.59 | 0.41 | 0.50 | 70.86 | ≤ 41 |
| Duration of using vasopressor (≥ 4 days vs. < 4 days) | |||||||||||
| Lactate/Albumin | 0.788 (0.714–0.850) | < 0.001* | 72.90 | 77.27 | 88.64 | 53.9 | 3.21 | 0.35 | 0.50 | 74.17 | > 0.1 |
| Lactate baseline | 0.537 (0.453–0.618) | 0.445 | 19.81 | 95.45 | 91.30 | 32.8 | 4.32 | 0.84 | 0.14 | 41.72 | > 4.2 |
| Lactate 6 h | 0.655 (0.573–0.731) | 0.007* | 67.92 | 59.09 | 79.69 | 35.6 | 1.62 | 0.74 | 0.27 | 54.30 | > 3.1 |
| Lactate 12 h | 0.749 (0.672–0.816) | < 0.001* | 45.28 | 95.45 | 96.00 | 41.6 | 9.87 | 0.56 | 0.40 | 59.60 | > 2.8 |
| Lactate 24 h | 0.801 (0.728–0.862) | < 0.001* | 52.83 | 97.73 | 98.25 | 45.7 | 23.1 | 0.49 | 0.50 | 65.56 | > 2.3 |
| Clearance lactate 6 h | 0.678 (0.596–0.753) | < 0.001* | 50.50 | 79.55 | 86.36 | 41.2 | 2.60 | 0.59 | 0.30 | 60.93 | ≤ 16.2 |
| Clearance lactate 12 h | 0.793 (0.718–0.856) | < 0.001* | 72.28 | 72.73 | 86.81 | 53.3 | 2.71 | 0.36 | 0.45 | 73.51 | ≤ 34 |
| Clearance lactate 24 h | 0.808 (0.734–0.869) | < 0.001* | 57.43 | 97.73 | 98.46 | 50.0 | 26.3 | 0.41 | 0.55 | 70.86 | ≤ 39.5 |
CI, confidence interval, SN, Sensitivity; SP, Specificity; LR+, Positive Likelihood Ratio; LR−, Negative Likelihood Ratio; PPV, Positive Predictive value; NPV, Negative Predictive value.
P < 0.05 considered as significant.