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Admission lactate and outcome after high-risk surgery
Critical Care volume 16, Article number: P261 (2012)
Introduction
The aim of this study was to assess the ability of serum lactate level in patients admitted to the ICU after surgery to predict outcome.
Methods
A retrospective, clinical observational study in patients undergoing high-risk surgery admitted to a 17-bed ICU of a large teaching hospital. Data were obtained during haemodynamic optimization using an established GDT protocol in the first 8 hours after admission and included demographic data as well as haemodynamic and laboratory parameters. Outcome data included morbidity (defined as >1 complications on the postoperative morbidity survey) and clinical outcome (hospital mortality, length of ICU stay, length of hospital stay, readmission to the ICU).
Results
Sixty-seven patients were included. Lactate clearance (decrease of lactate >10% in 2 hours) occurred in 64 patients (96%). Sixty patients developed at least one surgical complication. There were no significant correlation between lactate levels on admission and development of complications and length of hospital stay. Nine patients (13%) were readmitted to the ICU. A receiving operator characteristic analysis for readmission to the ICU showed an area under the curve of 0.79. A lactate higher than 1.7 mmol/l on admission had a sensitivity of 75% and a specificity of 74% to predict ICU readmission (Figure 1). Patients with a lactate on admission >1.7 mmol/l also had a longer length of ICU stay (Table 1).
Prediction of ICU readmission according to initial lactate concentration.
Conclusion
Lactate on admission correlates with length of ICU stay and readmission to the ICU.
References
Pearse R, et al.: Crit Care. 2005, 9: R687-R693. 10.1186/cc3887
Jansen TC, et al.: Am J Respir Crit Care Med. 2010, 182: 752-761. 10.1164/rccm.200912-1918OC
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Geisen, M., Aya, H., Ebm, C. et al. Admission lactate and outcome after high-risk surgery. Crit Care 16 (Suppl 1), P261 (2012). https://doi.org/10.1186/cc10868
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DOI: https://doi.org/10.1186/cc10868