Early lactate measurements for predicting in‐hospital mortality in paediatric sepsis

Aim We compared the performance of plasma lactate with high‐sensitivity C‐reactive protein (hs‐CRP), and paediatric sepsis‐related organ failure assessment (pSOFA) score for predicting mortality in septic children. Methods Serial plasma lactate and hs‐CRP levels and pSOFA score was assessed during early hospital stay in septic children. Results Out of 149 participants, 45 died. Plasma lactate at 0 h and 6 h was significantly higher, and lactate clearance was significantly lower in non‐survivors. The optimal cut‐off of plasma lactate at 6h for identifying mortality was 2.5 mmol/L (sensitivity 85% and specificity 74%). pSOFA score had the best predictive ability for mortality (AUC 0.89) followed by hs‐CRP at 0 h (AUC 0.86), hs‐CRP at 48 h (AUC 0.83), plasma lactate levels at 6 h (AUC 0.83), and plasma lactate at 0 h (AUC 0.67). Conclusion pSOFA score, hs‐CRP and hyperlactemia at 6 h can identify septic children at risk of dying.