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Objective <p>To investigate the role of lactate clearance rate (LCR) and Sequential Organ Failure Assessment (SOFA) score in prognostic assessment of patients with severe pneumonia (SP).</p> Methods <p>A retrospective study of 185 SP patients was conducted. Baseline characteristics were compared between survivors (<i>n</i> = 128) and non-survivors (<i>n</i> = 57). Following univariate and correlation analyses, significant variables were used to build a combined prediction model via binary logistic regression. Model calibration and predictive performance for 28-day mortality were assessed using Hosmer-Lemeshow and ROC curve analyses, respectively. Dynamic changes in LCR and SOFA scores at admission (T0), 6&#xa0;h (T6), and 24&#xa0;h (T24) were compared.</p> Results <p>The 28-day mortality rate was 30.81% (57/185). Univariate analysis revealed statistically significant differences in age, chronic lung disease, procalcitonin (PCT), LCR, and SOFA score (<i>P</i> &lt; 0.05). Spearman correlation analysis showed a moderate negative correlation between LCR and SOFA score (<i>r</i> = -0.401, <i>P</i> &lt; 0.001). Multivariate analysis identified LCR [0.911 (0.861–0.965)] and SOFA score [1.508 (1.278–1.779)] as independent predictors (<i>P</i> &lt; 0.05). The combined model demonstrated superior predictive accuracy (AUC: 0.882, 95% CI: 0.833–0.932) compared to LCR (AUC: 0.793) or SOFA score (AUC: 0.832) alone (Delong test, <i>P</i> &lt; 0.05). Survivors exhibited significantly higher LCR and lower SOFA scores at T6 and T24, with improving trends over time, unlike non-survivors.</p> Conclusion <p>The combined model integrating LCR and SOFA score outperforms either parameter alone in predicting 28-day mortality risk in SP, offering a potential tool for early risk stratification.</p>

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A combined model based on lactate clearance rate and SOFA score in prognostic assessment of patients with severe pneumonia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月2日

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  • Ying Chen,
  • Chuankai Liu,
  • Duandan Li,
  • Jun Yan,
  • Man Yi

摘要

Objective

To investigate the role of lactate clearance rate (LCR) and Sequential Organ Failure Assessment (SOFA) score in prognostic assessment of patients with severe pneumonia (SP).

Methods

A retrospective study of 185 SP patients was conducted. Baseline characteristics were compared between survivors (n = 128) and non-survivors (n = 57). Following univariate and correlation analyses, significant variables were used to build a combined prediction model via binary logistic regression. Model calibration and predictive performance for 28-day mortality were assessed using Hosmer-Lemeshow and ROC curve analyses, respectively. Dynamic changes in LCR and SOFA scores at admission (T0), 6 h (T6), and 24 h (T24) were compared.

Results

The 28-day mortality rate was 30.81% (57/185). Univariate analysis revealed statistically significant differences in age, chronic lung disease, procalcitonin (PCT), LCR, and SOFA score (P < 0.05). Spearman correlation analysis showed a moderate negative correlation between LCR and SOFA score (r = -0.401, P < 0.001). Multivariate analysis identified LCR [0.911 (0.861–0.965)] and SOFA score [1.508 (1.278–1.779)] as independent predictors (P < 0.05). The combined model demonstrated superior predictive accuracy (AUC: 0.882, 95% CI: 0.833–0.932) compared to LCR (AUC: 0.793) or SOFA score (AUC: 0.832) alone (Delong test, P < 0.05). Survivors exhibited significantly higher LCR and lower SOFA scores at T6 and T24, with improving trends over time, unlike non-survivors.

Conclusion

The combined model integrating LCR and SOFA score outperforms either parameter alone in predicting 28-day mortality risk in SP, offering a potential tool for early risk stratification.