Lactate and SOFA Score as Predictors of Sepsis Mortality: A Retrospective Observational Study

Authors

  • Anugerah Hardianti Department of Nursing, University of Brawijaya, Malang, East Java, Indonesia
  • Ahsan Ahsan Department of Nursing, University of Brawijaya, Malang, East Java, Indonesia
  • Heri Kristianto Department of Nursing, University of Brawijaya, Malang, East Java, Indonesia
  • Hasriadi Lande Emergency Department, Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia

DOI:

https://doi.org/10.55018/janh.v7i2.324

Keywords:

Biomarker, Emergency Room, Lactate Level, Sepsis, SOFA Score

Abstract

Background: Managing sepsis in the emergency room presents a significant challenge, as the condition is often difficult to recognize, leading to a delay in identification and diagnosis, frequently only after the patient has reached a critical state. This study aims to analyze the correlation between lactate levels and Sequential Organ Failure Assessment (SOFA) scores with mortality risk in patients with sepsis: a retrospective study conducted in the emergency room of Dr. Wahidin Sudirohusodo Hospital, Makassar. This study follows the STROBE guidelines for observational research.

Methods: This study employs a quantitative, analytical observational design with a retrospective approach. The sample consists of 321 sepsis patients diagnosed with sepsis or presenting comorbidities associated with sepsis in the Emergency Room of Dr. Wahidin Sudirohusodo Hospital, Makassar. The sample size was determined using the Slovin formula. Purposive sampling was employed as the sampling technique, while data analysis included descriptive statistics, chi-square tests, and binary logistic regression.

Results: Elevated lactate levels and SOFA scores were significantly associated with increased mortality (p <0.05). Lactate levels demonstrated an odds ratio (OR) of 5.329, indicating that patients with low lactate levels were 5.3 times more likely to survive than those with high lactate levels. The SOFA score produced an OR of 10.058, suggesting that patients with lower SOFA scores had a 10.1 times greater chance of survival compared to those with higher scores. Lactate level was identified as the primary predictor of mortality.

Conclusion: The results of this study indicate a significant correlation between blood lactate levels and SOFA scores with sepsis-related mortality in the Emergency Department (ED). Among these two parameters, blood lactate emerged as the most dominant predictor. These results underscore the importance of implementing early detection tools for sepsis, such as lactate testing and simplified SOFA assessments, as part of routine triage workflows, particularly at Dr. Wahidin Sudirohusodo General Hospital in Makassar.

Downloads

Download data is not yet available.

References

Ahsan, A., Rahmawati, I. N., Noviyanti, L. W., Harwiati Ningrum, E., Nasir, A., & Harianto, S. (2023). The Effect of the Application of the Team-STEPPS-Based Preceptorship Guidance Model on the Competence of Nursing Students. Advances in Medical Education and Practice, Volume 14, 817–826. https://doi.org/10.2147/AMEP.S416847

Anjelin, I. K., Freddy, A., Nugroho, S. E. A., & Setijowati, N. (2020). Penggunaan Nicas Sebagai Pengganti Asam Laktat Untuk Mengevaluasi Keberhasilan Resusitasi Sepsis Dan Syok Sepsis. Majalah Kesehatan, 7(3), 173–182. https://doi.org/10.21776/ub.majalahkesehatan.2020.007.03.4

Blair, P. W., Mehta, R., Oppong, C. K., Tin, S., Ko, E., Tsalik, E. L., Chenoweth, J., Rozo, M., Adams, N., Beckett, C., Woods, C. W., Striegel, D. A., Salvador, M. G., Brandsma, J., McKean, L., Mahle, R. E., Hulsey, W. R., Krishnan, S., Prouty, M., … Clark, D. V. (2023). Screening tools for predicting mortality of adults with suspected sepsis: An international sepsis cohort validation study. BMJ Open, 13(2), e067840. https://doi.org/10.1136/bmjopen-2022-067840

Donaliazarti. (2022). Peran Laktat Pada Sepsis Dan Pemeriksaan Laboratoriumnya. Scientific Journal, 1(4), 269–277. https://doi.org/10.56260/sciena.v1i4.53

D’Onofrio, V., Meersman, A., Vijgen, S., Cartuyvels, R., Messiaen, P., & Gyssens, I. (2020). Risk Factors for Mortality, Intensive Care Unit Admission, and Bacteremia in Patients Suspected of Sepsis at the Emergency Department: A Prospective Cohort Study. Open Forum Infectious Diseases, 8. https://doi.org/10.1093/ofid/ofaa594

Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., Prancis, C., Mcintyre, L., Ostermann, M., Schorr, C., Simpson, S., Wiersinga, W. J., Alshamsi, F., Angus, D. C., Arabi, Y., Beilman, G., BelleyÿCote, E., Burry, L., Cecconi, M., Centofanti, J., … Zimmerman, J. (2021). Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021. Springer Nature, 47, 1181–1247. https://doi.org/doi: 10.1007/s00134-021-06506-y https://doi.org/10.1097/CCM.0000000000005337

Hatman, F. A., Semedi, B. P., & Budiono, B. (2021). Analisis Faktor Risiko terhadap Lama Perawatan Pasien Sepsis yang Meninggal di Ruang Perawatan Intensif RSUD Dr. Soetomo Surabaya. JAI (Jurnal Anestesiologi Indonesia), 13(2), 78–87. https://doi.org/10.14710/jai.v13i2.32441

Iskandar, A., & Siska, F. (2020). Analisis Hubungan Sequential Organ Failure Assessment (Sofa) Score Dengan Mortalitas Pasien Sepsis. Jurnal Kesehatan Andalas, 9(2), 168. https://doi.org/10.25077/jka.v9i2.1221

Jarczak, D., Kluge, S., & Nierhaus, A. (2021). Sepsis—Pathophysiology and Therapeutic Concepts. Frontiers in Medicine, 8, 628302. https://doi.org/10.3389/fmed.2021.628302

Lee, J. H., Kim, S.-H., Jang, J. H., Park, J. H., Jo, K. M., No, T.-H., Jang, H.-J., & Lee, H.-K. (2022). Clinical usefulness of biomarkers for diagnosis and prediction of prognosis in sepsis and septic shock. Medicine, 101(48), e31895. https://doi.org/10.1097/MD.0000000000031895

Machado, F. R., Cavalcanti, A. B., Braga, M. A., Tallo, F. S., Bossa, A., Souza, J. L., Ferreira, J. F., Pizzol, F. D., Monteiro, M. B., Angus, D. C., Lisboa, T., Azevedo, L. C. P., The SPREAD ED Investigators, the Instituto Latino Americano de Sepsis Network, Alves, S. Z. S. P., Velasco, C. B., Sanches, G. F., Azevedo, L. N., Sobrinho, E. B., Veríssimo, A. O. L., … Pancini, T. R. (2023). Sepsis in Brazilian emergency departments: A prospective multicenter observational study. Internal and Emergency Medicine, 18(2), 409–421. https://doi.org/10.1007/s11739-022-03179-3

Mila, M., & Nursanti, I. (2024). Teori Keperawatan Myra Estrin Levine dan Aplikasinya. SAINTEKES: Jurnal Sains, Teknologi Dan Kesehatan, 3(1), 50–56. https://doi.org/10.55681/saintekes.v3i1.296

Moreira, D. A. A., Braga, D. V., Viana, M. C. A., Oliveira, D. R. D., Oliveira, C. J. D., & Cavalcante, E. G. R. (2022). Assistência de enfermagem ao paciente com sepse: Análise à luz do modelo conceitual de Myra Levine. Escola Anna Nery, 26, e20210368. https://doi.org/10.1590/2177-9465-ean-2021-0368

Pratafa, G. A., Novitasari, D., & Safitri, M. (2022). Gambaran Pengetahuan tentang Triage dan Ketepatan Pelaksanaan Triage pada Mahasiswa Profesi Ners Universitas Harapan Bangsa. 8.

Purwanto, D. S., & Astrawinata, D. A. W. (2018). Mekanisme Kompleks Sepsis dan Syok Septik. Jurnal Biomedik (JBM), 10(3), 143. https://doi.org/10.35790/jbm.10.3.2018.21979

Rhodes, A., Evans, L. E., Alhazzani, W., Levy, M. M., Antonelli, M., Ferrer, R., Kumar, A., Sevransky, J. E., Sprung, C. L., Nunnally, M. E., Rochwerg, B., Rubenfeld, G. D., Angus, D. C., Annane, D., Beale, R. J., Bellinghan, G. J., Bernard, G. R., Chiche, J.-D., Coopersmith, C., … Dellinger, R. P. (2017). Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Medicine, 43(3), 304–377. https://doi.org/10.1007/s00134-017-4683-6

Risnah, S., & Irwan, M. (2021). Falsafah Dan Teori Keperawatan Dalam Integritas Keilmuan. Alauddin University Press. https://repositori.uin-alauddin.ac.id.Buku Falsafah Dan Teori Keperawatan Dalam Integrasi Keilmuan.pdf

Rudiyanto, Ariyani, A. D., Rahmawan, F. A., Prasetyawan, R. D., & Rosuli, A. (2021). Buku Ajar Asuhan Keperawatan Kasus Trauma. STIKES Banyuwangi.

Sari, E. K., Hayati, Y. S., & Rokhmawati, N. L. (2021). Hubungan Skor SOFA Dengan Mortalitas Pada Pasien Sakit Kritis. Majalah Kesehatan, 8(3), 149–155. https://doi.org/10.21776/ub.majalahkesehatan.2021.008.03.4

Wiguna, Y. W., Setiawan, P., Semedi, B. P., & Purwanto, B. (2021). Syndecan-1 Laktat dan Profil Lipid sebagai Faktor Risiko Keparahan dan Mortalitas Sepsis. Jurnal Anestesi Perioperatif, 9(1), 18–26. https://doi.org/10.15851/jap.v9n1.2251

Downloads

Published

2025-07-08

How to Cite

Hardianti, A., Ahsan, A., Kristianto, H. ., & Lande, H. . (2025). Lactate and SOFA Score as Predictors of Sepsis Mortality: A Retrospective Observational Study. Journal of Applied Nursing and Health, 7(2), 138–149. https://doi.org/10.55018/janh.v7i2.324