Lactate Is a Strong Predictor of Poor Outcomes in Patients with Severe Traumatic Brain Injury

<b>Background:</b> Lactate is a byproduct of glycolysis, often linked to oxygen deprivation. This study aimed to examine how lactate levels (LLs) affect clinical outcomes in patients with severe TBI, hypothesizing that higher LLs would correlate with worse outcomes. <b>Methods</b>: This is a level 1 single-center, retrospective study of patients with severe TBI between 1 January 2020 and 31 December 2023, inclusive. <b>Results:</b> Single-factor ANOVA indicated a significant decrease in LLs with increasing age. Linear regression models showed the same for hospital admission, Intensive Care Unit (ICU) admission LLs, and death LLs. Prognostic scores such as Injury Severity Scores (ISS) and Glasgow Coma Score (GCS) showed a strong correlation with both Hospital admission and ICU admission LLs. ANOVA indicated higher LLs with increasing ISS and increasing LLs with decreasing GCS. Linear regressions revealed a strong positive correlation between ISS and LLs. On linear regression, the LL measured at hospital admission and ICU admission was positively associated with the length of stay (LOS) in the hospital, LOS in the ICU, ventilator days, and mortality. Linear regression models showed that a decreased delta LL during ICU admission led to an increased LOS at the hospital and the ICU, as well as a higher number of days on a ventilator. <b>Discussion:</b> We discovered that high LLs were linked to higher AIS and GCS scores, longer stays in the hospital and ICU, more days requiring a ventilator, and higher mortality rates in patients with severe TBI. <b>Conclusions:</b> LLs can be considered a strong predictor of poor clinical outcomes in patients with severe TBI.