The present study underscores the significant prognostic value of lactate trajectories in critically ill patients, particularly those with hyperlactatemia.

Our findings suggest that rapid lactate clearance is strongly associated with improved outcomes, while persistently elevated lactate levels reflect ongoing hypoxic or metabolic stress, leading to a higher risk of mortality and acute kidney injury (AKI).

The use of a multicenter study design enhances the generalizability of these findings, and the application of GBTM enables more precise risk stratification, allowing clinicians to better predict patient outcomes based on dynamic lactate trends.

Future prospective studies are necessary to validate these findings and explore targeted interventions aimed at reducing lactate levels more effectively, which may help mitigate the risk of organ dysfunction and improve overall survival in critically ill patients with hyperlactatemia.

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