# Predictive Value of Normalized Lactate Load for Patients with Acute Type A Aortic Dissection: Based on the MIMIC-IV Database

## TL;DR

This study shows that normalized lactate load can predict mortality risk in patients with acute type A aortic dissection.

## Contribution

The study introduces normalized lactate load as a novel early-warning biomarker for 30-day mortality in acute type A aortic dissection patients.

## Key findings

- Normalized lactate load is a significant risk factor for 30-day mortality in AAAD patients.
- NLL showed strong predictive value with AUCs of 0.781 for 7- and 14-day mortality.
- High NLL groups had significantly worse 30-day survival compared to low NLL groups.

## Abstract

The objective of this study was to examine the correlation between normalized lactate load (NLL) and the 30-day mortality rate in patients with acute type A aortic dissection (AAAD) patients, as well as its predictive value for prognosis.

Data were obtained from the Medical Information Mart for Intensive Care-IV database. The Cox model and restricted cubic spline (RCS) were used to assess the relationship between NLL and 30-day mortality in AAAD patients. Receiver-operating characteristic curves were plotted to evaluate the predictive value of NLL for 7-, 14-, and 30-day mortality. Kaplan–Meier (K–M) curves were used to compare 30-day survival across different risk levels.

Among 150 AAAD patients, NLL was recognized as a risk factor for 30-day mortality (hazard ratio = 1.83, 95% confidence interval: 1.29–2.58; P <0.001). The RCS analysis showed a linear relationship. NLL showed areas under the curve of 0.781, 0.781, and 0.730 for predicting 7-, 14-, and 30-day mortality, respectively. K–M curves revealed a significant difference in 30-day survival between the high- and low-risk groups (log-rank P = 0.042).

NLL is a risk factor for 30-day mortality in AAAD patients and shows good predictive value. This study supports NLL as an early-warning biomarker for identifying high-risk AAAD patients.