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The association between lactate, mean arterial pressure, central venous oxygen saturation and peripheral temperature and mortality in severe sepsis: a retrospective cohort analysis

Overview of attention for article published in Critical Care, January 2016
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (95th percentile)
  • High Attention Score compared to outputs of the same age and source (90th percentile)

Mentioned by

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93 tweeters
facebook
1 Facebook page

Citations

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69 Dimensions

Readers on

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152 Mendeley
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Title
The association between lactate, mean arterial pressure, central venous oxygen saturation and peripheral temperature and mortality in severe sepsis: a retrospective cohort analysis
Published in
Critical Care, January 2016
DOI 10.1186/s13054-016-1243-3
Pubmed ID
Authors

Aletta P. I. Houwink, Saskia Rijkenberg, Rob J. Bosman, Peter H. J. van der Voort, Houwink, Aletta P I, Rijkenberg, Saskia, Bosman, Rob J, van der Voort, Peter H J

Abstract

During resuscitation in severe sepsis and septic shock, several goals are set. However, usually not all goals are equally met. The aim of this study is to determine the relative importance of the different goals, such as mean arterial pressure (MAP), lactate, central venous oxygen saturation (ScvO2) and central to forefoot temperature (delta-T), and how they relate to intensive care unit (ICU) and hospital mortality. In a retrospective cohort study in a 20-bed mixed medical and surgical ICU of a teaching hospital we studied consecutive critically ill patients who were admitted for confirmed infection and severe sepsis or septic shock between 2008 and 2014. All validated MAP, lactate levels, ScvO2 and delta-T for the first 24 hours of ICU treatment were extracted from a clinical database. Logistic regression analyses were performed on validated measurements in the first hour after admission and on mean values over 24 hours. Patients were categorized by MAP (24-hour mean below or above 65 mmHg) and lactate (24-hour mean below or above 2 mmol/l) for Cox regression analysis. From 837 patients, 821 were eligible for analysis. All had MAP and lactate measurements. The delta-T was available in 812 (99 %) and ScvO2 was available for 193 out of these patients (23.5 %). Admission lactate (p < 0.001) and admission MAP (p < 0.001) were independent predictors of ICU and hospital mortality. The 24-hour mean values for lactate, MAP and delta-T were all independent predictors of ICU mortality. Hospital mortality was independently predicted by the 24-hour mean lactate (odds ratio (OR) 1.34, 95 % confidence interval (CI) 1.30-1.40, p = 0.001) mean MAP (OR 0.96, 95 % CI 0.95-0.97, p = 0.001) and mean delta-T (OR 1.09, 95 % CI 1.06-1.12, p = 0.001). Patients with a 24-hour mean lactate below 2 mmol/l and a 24-hour mean MAP above 65 mmHg had the best survival, followed by patients with a low lactate and a low MAP. Admission MAP and lactate independently predicted ICU and hospital mortality. The 24-hour mean lactate, mean MAP and mean delta-T independently predicted hospital mortality. A Cox regression analysis showed that 24-hour mean lactate above 2 mmol/l is the strongest predictor for ICU mortality.

Twitter Demographics

The data shown below were collected from the profiles of 93 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 152 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Mexico 1 <1%
Unknown 151 99%

Demographic breakdown

Readers by professional status Count As %
Researcher 25 16%
Other 18 12%
Student > Master 17 11%
Student > Doctoral Student 13 9%
Student > Bachelor 13 9%
Other 41 27%
Unknown 25 16%
Readers by discipline Count As %
Medicine and Dentistry 92 61%
Nursing and Health Professions 8 5%
Agricultural and Biological Sciences 6 4%
Engineering 3 2%
Biochemistry, Genetics and Molecular Biology 2 1%
Other 10 7%
Unknown 31 20%

Attention Score in Context

This research output has an Altmetric Attention Score of 58. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 May 2016.
All research outputs
#565,795
of 21,550,416 outputs
Outputs from Critical Care
#422
of 5,840 outputs
Outputs of similar age
#11,470
of 278,932 outputs
Outputs of similar age from Critical Care
#4
of 31 outputs
Altmetric has tracked 21,550,416 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,840 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.8. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 278,932 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 95% of its contemporaries.
We're also able to compare this research output to 31 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 90% of its contemporaries.