{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:59:37Z","timestamp":1790949577321,"version":"4.1.0"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Phlebology"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Admission lactate carries prognostic information in acute pulmonary embolism (PE), but the value of its early change in patients receiving systemic thrombolysis is unclear. We examined the association between 24-h lactate dynamics and an adverse in-hospital clinical course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective single-centre cohort, 40 consecutive adults who received systemic alteplase for acute PE (2024\u20132025) were analysed. In 35 patients the 24-h sample followed thrombolysis. The primary outcome was a composite adverse event (complicated or fatal clinical course). Admission (T0) and 24-h (T24) lactate, absolute \u0394 lactate and percentage clearance were assessed by ROC analysis and Firth-penalised logistic regression with 2000-resample bootstrap internal validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The composite event occurred in 12 patients (30%). Admission lactate did not discriminate the outcome (AUC 0.56), whereas \u0394 lactate and percentage clearance did (AUC 0.88 for both; 95% CI 0.76\u20130.99 and 0.77\u20130.99, respectively; DeLong\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.84, the two AUCs did not differ). A \u0394 \u2265 0\u00a0mmol\/L identified an adverse course with a sensitivity of 0.75 and a specificity of 0.82, and a T24 \u2265 4\u00a0mmol\/L gave a specificity of 1.00. The association of \u0394 lactate persisted after adjustment for age and showed minimal optimism on bootstrap internal validation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this selected cohort receiving systemic thrombolysis, admission lactate did not reproduce the discrimination reported in broader PE populations, whereas 24-h lactate dynamics showed a stronger association with the adverse in-hospital course. \u0394 lactate should be regarded as a marker of concurrent severity rather than a predictor of treatment response; the candidate thresholds are hypothesis-generating and require prospective validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02683555261493219","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:02:01Z","timestamp":1790668921000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Twenty-four-hour lactate dynamics and adverse in-hospital outcomes in acute pulmonary embolism treated with systemic thrombolysis: A retrospective cohort study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3398-3878","authenticated-orcid":false,"given":"Orkun Eray","family":"Terzi","sequence":"first","affiliation":[{"name":"University of Health Sciences"},{"name":"Bursa Y\u00fcksek \u0130htisas Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fclg\u00fcn","family":"\u00c7etinta\u015f Af\u015far","sequence":"additional","affiliation":[{"name":"University of Health Sciences"},{"name":"Bursa Y\u00fcksek 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Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lpm.2024.104243"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/02683555221081818"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/pul2.70254"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz405"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000132904.35713.A7"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2102953"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/80.1.27"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1047"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2105-12-77"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2021.01.021"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2026.102755"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2025.110942"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-021-02576-3"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2024.04.025"}],"container-title":["Phlebology: The Journal of Venous 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