Lactate/Pyruvate Serum Ratio as a Clinical Prognostic Marker for Severe Septic Patients Evolution

This is the authors' abstract. We don't add key points for this paper.

Introduction Various studies have shown that an increase in the lactate/pyruvate (L/P) ratio is associated with higher mortality. In some patients, despite the development of hyperlactatemia, the L/P ratio remains preserved. We determined the impact of variations in lactate, pyruvate, and the L/P ratio on mortality. Material and methods We recruited patients above 18 years with sepsis without shock. On admission, we measure lactate, C-reactive protein, lactate, pyruvate. All tests were performed 0, 4, and 8 hours after admission. The SOFA score, APACHE-II, and Shock Index were measured in all participants. All patients had a 30-day follow-up. Results Eighteen patients in our cohort died, with an overall mortality of 21.6%. The most prevalent post-mortem diagnosis was pneumonia (50%), followed by sepsis of abdominal origin (38.9%), being statistical relevant (p = 0.002). An improvement of at least 30% in the L/P ratio in the next 4 hrs upon arrival at the emergency room confers a protective effect on short term in patients with severe sepsis. Conclusion The L/P ratio appears to be a good and earlier predictor regarding hyperlactatemia and/or hypopyruvatemia. The evaluation of L/P over time is more important, with its ratio > 25 on 4 hrs posterior to hospital admission as the cut-off point associated with higher mortality.