Abstract Background The relationship between lactate to creatinine ratio (LCR) and prognosis in pediatric sepsis is poorly understood. Our study aimed to investigate the association between LCR and hospital mortality in pediatric sepsis patients. Methods A retrospective cohort study of 4379 patients with pediatric sepsis, categorized by LCR quartiles, was performed. The association between LCR and hospital mortality was investigated using univariate and multivariate logistic regression models, as well as subgroup and sensitivity analyses. Restricted cubic splines were employed to explore non-linear relationships, and a two-piece logistic proportional hazards model was constructed for both sides of the inflection point. Results The overall hospital mortality rate for pediatric sepsis was 9.6%. Following adjustment for relevant covariates, a positive correlation between LCR and hospital mortality was observed. A nonlinear relationship between the baseline LCR and the risk of hospital mortality was identified, with LCR < 0.780 associated with a significantly higher risk. Beyond the LCR turning point of 0.780, the risk did not substantially increase. Conclusions The study revealed a nonlinear relationship between the LCR and hospital mortality in children with sepsis. When the LCR is less than 0.780, hospital mortality rises drastically as the LCR advances. Impact This research delves into the non-linear correlation between the lactate to creatinine ratio (LCR) and hospital mortality in pediatric sepsis patients. It identifies a critical threshold of LCR < 0.780 linked to higher mortality rates. This study presents the first comprehensive analysis of LCR’s significance in pediatric sepsis, suggesting it as a potential biomarker for risk assessment and clinical decision-making. The implications of these findings could potentially lead to improved treatment strategies, ultimately decreasing hospital mortality in children with sepsis by optimizing lactate and creatinine management.
Cai et al. (Wed,) studied this question.