Evidence mapPaperPMID 38243243Full record

ArticleMalaria journal2024

Post hospital admission blood lactate measurements are associated with mortality but not neurologic morbidity in children with cerebral malaria.

Ronke Olowojesiku, Meredith G Sherman, Amina M Mukadam, Rami Imam, Kennedy M Chastang, Karl B Seydel, Alice M Liomba, John R Barber, Nicole F O'Brien, Douglas G Postels

Open access · goldAbstract read
In one paragraph

Article in Malaria journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.1field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 1 country.

Ronke OlowojesikuDepartment of Pediatrics, Children's National Hospital, Washington, DC, USA.
Meredith G ShermanGlobal Health Initiative, Children's National Hospital, Washington, DC, USA.
Amina M MukadamUniversity of Washington, Seattle, WA, USA.
Rami ImamThe George Washington University School of Medicine, Washington, DC, USA.
Kennedy M ChastangHoward University, Washington, DC, USA.
Karl B SeydelMichigan State University, East Lansing, MI, USA.
Alice M LiombaKamuzu University of Health Sciences, Blantyre Malaria Project, Blantyre, Malawi.
John R BarberDivision of Biostatistics and Study Methodology, Children's National Research Institute, Washington, DC, USA.
Nicole F O'BrienKamuzu University of Health Sciences, Blantyre Malaria Project, Blantyre, Malawi.
Douglas G PostelsKamuzu University of Health Sciences, Blantyre Malaria Project, Blantyre, Malawi. dpostels@childrensnational.org.
Children's National · USKamuzu University of Health SciencesGeorge Washington University · USHoward University · USNationwide Children's Hospital · USUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn children with cerebral malaria (CM) admission blood lactate has previously guided intravenous fluid therapy and been validated as a prognostic biomarker associated with death. The usefulness of post-admission measurements of blood lactate in children with CM is less clear. The strength of association between blood lactate and neurological sequelae in CM survivors, as well as the optimal duration of post-admission measurements of blood lactate to identify children at higher risk of adverse outcomes is unknown.

methodsA retrospective cohort study of 1674 Malawian children with CM hospitalized from 2000 to 2018 who had blood lactate measurements every 6 h for the first 24 h after admission was performed. The strength of association between admission lactate or values measured at any time point in the first 24 h post-admission and outcomes (mortality and neurological morbidity in survivors) was estimated. The duration of time after admission that lactate remained a valid prognostic biomarker was assessed.

resultsWhen lactate is analysed as a continuous variable, children with CM who have higher values at admission have a 1.05-fold higher odds (95% CI 0.99-1.11) of death compared to those with lower lactate values. Children with higher blood lactate at 6 h have 1.16-fold higher odds (95% CI 1.09-1.23) of death, compared to those with lower values. If lactate levels are dichotomized into hyperlactataemic (lactate > 5.0 mmol/L) or not, the strength of association between admission lactate and mortality increases (OR = 2.49, 95% CI 1.47-4.22). Blood lactate levels obtained after 18 h post-admission are not associated with outcomes. Similarly, the change in lactate concentrations through time during the first 24 h of hospital admission is not associated with outcomes. Blood lactate during hospitalization is not associated with adverse neurologic outcomes in CM survivors.

conclusionsIn children with CM, blood lactate is associated with death but not neurologic morbidity in survivors. To comprehensively estimate prognosis, blood lactate in children with CM should be assessed at admission and for 18 h afterwards.

Indexed as

Malaria, CerebralBiomarkersChildHospitalsHumansLactic AcidMorbidityRetrospective StudiesBiomarkersLactic AcidAfricaLactateMalariaMalawiPaediatric

Identifiers

PMID38243243
PMCPMC10797711
OpenAlexW4391034737

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.