Lactate is a chemical produced by the body as cells consume energy - in times of stress more lactate is produced. In the past, we thought that lactate was just a waste product, but more recently we have learned that lactate has an important role to play in the body.

People suffering from certain severe illnesses may have a high ‘lactate’ level in their blood. This is particularly common in the following:

Severe infections which the body cannot properly control (sepsis)

People who have sustained severe injuries (traumatic injury)

People who are critically unwell with other illnesses (needing treatment in an intensive care unit)

Some patients will develop a high lactate level when they are in hospital. Doctors recognise that this indicates the patient is becoming more unwell, but it is often challenging to know exactly what is causing the lactate level to be raised.

Raised lactate level has been associated with worse outcome in other syndromes, including major trauma and undifferentiated critical illness; however healthy individuals may generate very high lactate levels during strenuous exercise from which they recover without any harm. It is unclear whether lactate in itself is harmful to patients. This dataset provides unique insight into the potential role of lactate as not only a biomarker but a therapeutic target in acute illness.

PIONEER geography The West Midlands (WM) has a population of 5.9 million and includes a diverse ethnic and socio-economic mix.

EHR. UHB is one of the largest NHS Trusts in England, providing direct acute services and specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds and an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary and secondary care record (Your Care Connected) and a patient portal “My Health”.

Scope: Longitudinal and individually linked, so that the preceding and subsequent health journey can be mapped and healthcare utilisation prior to and after admission understood. The dataset includes highly granular patient demographics, co-morbidities taken from ICD-10 and SNOMED-CT codes. Serial, structured data pertaining to process of care (timings, admissions, wards), presenting complaint, physiology readings (BMI, temperature and weight), Sample analysis results (blood sodium level, lactate, haemoglobin, oxygen saturations, and others) drug administered and all outcomes.

Available supplementary data: Matched controls; ambulance, OMOP data, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform and load) process, Clinical expertise, Patient and end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.