Time-weighted lactate and glucose-lactate ratio outperform static values in ICU mortality prediction after traumatic brain injury: a retrospective cohort study.

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. These findings underscore the importance of longitudinal monitoring and support prioritizing lactate in multiparametric prognostic model to account for secondary injuries. Prospective validation is warranted to confirm external validity and assess therapeutic implications.