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Primary outcome is admission lactate association with 28-day mortality; secondary outcomes include ICU stay, ventilation duration, and accuracy versus APACHE II and 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(2026) 38:14  \n[https://doi.org/10.1007/s40520-025-03261-8](https://doi.org/10.1007/s40520-025-03261-8)  \nRESEARCH  \nAdmission lactate and short-term mortality in the geriatric ICU: comparison with established severity scores  \nAhmet Düzgün1 · Burhan Sami Kalın  \nReceived: 22 September 2025 / Revised: 20 October 2025 / Accepted: 3 November 2025 © The Author(s) 2025  \nAbstract  \nAim This study aims to investigate the prognostic value of admission lactate level in predicting 28-day mortality among geriatric patients admitted to the intensive care unit (ICU) and to compare its performance with established severity scores, including APACHE II and SOFA.  \nMaterials and methods In this retrospective cohort study, data of patients aged ≥ 65 years who were admitted to a tertiary ICU between December 2024 and June 2025 were analyzed. Patients with ICU stays \u003C 24 h or incomplete records were excluded. Demographic characteristics, comorbidities, admission lactate, APACHE II, and SOFA scores were recorded. The primary outcome was the association between admission lactate and 28-day mortality. Secondary outcomes included ICU length of stay, mechanical ventilation duration, and comparative prognostic accuracy of lactate versus APACHE II and SOFA.  \nResults A total of 241 patients were included. The 28-day mortality rate was 32.8%. Non-survivors had significantly higher admission lactate levels compared to survivors (6.29 ± 5.42 vs. 2.44 ± 1.80 mmol/L, p\u003C 0.001) . In multivariable logistic regression, admission lactate remained an independent predictor of mortality after adjustment for age, sex, comorbidity, and APACHE II (OR 1.29, 95% CI 1.09–1.52, p= 0.003). ROC analysis showed that lactate predicted 28-day mortality with an AUC of 0.77, compared to 0.92 for APACHE II and 0.88 for SOFA. Mortality increased across lactate categories: 14.2%(\u003C 2 mmol/L), 27.8%(2–4 mmol/L), and 62.5%(> 4 mmol/L) (p\u003C 0.001) .  \nConclusion Admission lactate is a simple and readily obtainable biomarker that independently predicts short-term mortality in geriatric ICU patients. While not outperforming established severity scores, lactate provides immediate risk stratification at the bedside and may aid clinical decision-making in this vulnerable population.  \nKeywords Lactate · Geriatric patients · Intensive care unit · APACHE II · SOFA · Mortality · Biomarker  \nIntroduction  \nEarly identification of high-risk patients is a cornerstone of intensive care medicine. Predicting mortality in critically ill individuals allows clinicians to guide therapeutic interventions, optimize resource allocation, and improve outcomes [1] . Several prognostic scoring systems, such as the Acute Physiology and Chronic Health Evaluation II (APACHE  \n􀀍 Ahmet Düzgün[a.duzgun47@gmail.com](a.duzgun47@gmail.com)  \nBurhan Sami Kalın  \n[bskalin@windowslive.com](bskalin@windowslive.com)  \n1 Department of Intensive Care, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye  \nII) and the Sequential Organ Failure Assessment (SOFA), are widely used in daily practice to estimate prognosis. Although these scores are well validated, their calculation requires the collection of multiple physiological and laboratory parameters, which may delay risk stratification in urgent clinical settings [2, 3] .  \nSerum lactate has emerged as a simple and rapidly obtainable biomarker that reflects the balance between oxygen delivery and tissue demand. Elevated lactate levels are considered an indicator of impaired cellular oxygen utilization, tissue hypoperfusion, or increased anaerobic metabolism [4, 5]. Numerous studies in heterogeneous ICU populations have demonstrated that admission lactate concentration, as well as lactate clearance, are strongly associated with mortality. Proposed cut-off values of 2 mmol/L and 4 mmol/L  \n1 3  \nare frequently cited in the literature as clinically relevant thresholds for risk stratification [6, 7] .  \nHowever, mo","cbCaiuTkxFqkymaZ","https://ap.wps.com/l/cbCaiuTkxFqkymaZ","pdf",927135,"English","# Abstract\n## Aim\n## Materials and methods\n## Results\n## Conclusion\n# Introduction\n# Materials and methods\n## Study design and setting\n## Ethical approval\n## Patient population","[{\"question\":\"What was the main objective of the study?\",\"answer\":\"To assess the prognostic value of admission lactate for predicting 28-day mortality in geriatric ICU patients and compare it with established severity scores.\"},{\"question\":\"How were patients selected for analysis?\",\"answer\":\"A retrospective cohort included patients aged ≥65 admitted to a tertiary ICU between December 2024 and June 2025, excluding ICU stays under 24 hours or incomplete records.\"},{\"question\":\"What did the results show about admission lactate and mortality?\",\"answer\":\"Higher admission lactate was associated with higher 28-day mortality, and lactate remained an independent predictor after adjustment including age, sex, comorbidities, and APACHE II.\"}]","Admission lactate and short-term mortality in the geriatric ICU - comparison with established severity scores | PDF",1790561794,18]