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Title: Association between serum lactate level during cardiopulmonary resuscitation and survival in adult out-of-hospital cardiac arrest: a multicenter cohort study
Authors: Nishioka, Norihiro
Kobayashi, Daisuke  KAKEN_id  orcid (unconfirmed)
Izawa, Junichi
Irisawa, Taro
Yamada, Tomoki
Yoshiya, Kazuhisa
Park, Changhwi
Nishimura, Tetsuro
Ishibe, Takuya
Yagi, Yoshiki
Kiguchi, Takeyuki  kyouindb  KAKEN_id
Kishimoto, Masafumi
Inoue, Toshiya
Hayashi, Yasuyuki
Sogabe, Taku
Morooka, Takaya
Sakamoto, Haruko
Suzuki, Keitaro
Nakamura, Fumiko
Matsuyama, Tasuku
Okada, Yohei
Matsui, Satoshi
Hirayama, Atsushi
Yoshimura, Satoshi
Kimata, Shunsuke
Shimazu, Takeshi
Kitamura, Tetsuhisa
Kawamura, Takashi  KAKEN_id
Iwami, Taku  kyouindb  KAKEN_id  orcid (unconfirmed)
the CRITICAL Study Group Investigators
Author's alias: 西岡, 典宏
小林, 大介
井澤, 純一
入澤, 太郎
山田, 知輝
吉矢, 和久
西村, 哲郎
石部, 琢也
八木, 良樹
木口, 雄之
岸本, 正文
井上, 稔也
林, 靖之
曽我部, 拓
師岡, 誉也
坂本, 晴子
鈴木, 慧太郎
中村, 文子
松山, 匡
岡田, 遥平
松井, 鋭
平山, 敦士
吉村, 聡志
木全, 俊介
嶋津, 岳士
北村, 哲久
川村, 孝
石見, 拓
Keywords: Cardiology
Cardiovascular diseases
Prognostic markers
Issue Date: 15-Jan-2021
Publisher: Springer Nature
Journal title: Scientific Reports
Volume: 11
Thesis number: 1639
Abstract: We aimed to investigate the association between serum lactate levels during cardiopulmonary resuscitation (CPR) and survival in patients with out-of-hospital cardiac arrest (OHCA). From the database of a multicenter registry on OHCA patients, we included adult nontraumatic OHCA patients transported to the hospital with ongoing CPR. Based on the serum lactate levels during CPR, the patients were divided into four quartiles: Q1 (≤ 10.6 mEq/L), Q2 (10.6–14.1 mEq/L), Q3 (14.1–18.0 mEq/L), and Q4 (> 18.0 mEq/L). The primary outcome was 1-month survival. Among 5226 eligible patients, the Q1 group had the highest 1-month survival (5.6% [74/1311]), followed by Q2 (3.6% [47/1316]), Q3 (1.7% [22/1292]), and Q4 (1.0% [13/1307]) groups. In the multivariable logistic regression analysis, the adjusted odds ratio of Q4 compared with Q1 for 1-month survival was 0.24 (95% CI 0.13–0.46). 1-month survival decreased in a stepwise manner as the quartiles increased (p for trend < 0.001). In subgroup analysis, there was an interaction between initial rhythm and survival (p for interaction < 0.001); 1-month survival of patients with a non-shockable rhythm decreased when the lactate levels increased (p for trend < 0.001), but not in patients with a shockable rhythm (p for trend = 0.72). In conclusion, high serum lactate level during CPR was associated with poor 1-month survival in OHCA patients, especially in patients with non-shockable rhythm.
Rights: © The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
DOI(Published Version): 10.1038/s41598-020-80774-4
PubMed ID: 33452306
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