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Table 1 Comparison of patients with metformin-associated lactic acidosis with patients with lactic acidosis of other origin

From: Outcome of severe lactic acidosis associated with metformin accumulation

 

All patients (n= 197)

MALA (n= 10)

LAOO (n= 187)

Post-cardiac arrest (n= 72)

Septic shock (n= 42)

Cardiogenic shock (n= 39)

Mesenteric ischemia (n= 8)

Hemorrhagic shock (n= 13)

Other causes (n= 13)

Age, years

67 ± 13

66 ± 9

67 ± 13

65 ± 13

68 ± 12

73 ± 11

72 ± 9

64 ± 15

56 ± 14

Male gender

121 (61%)

4 (40%)

117 (63%)

45 (62%)

24 (57%)

26 (67%)

6 (75%)

7 (54%)

9 (69%)

SAPS II

74 ± 20

88 ± 23

73 ± 19a

81 ± 16

71 ± 19a

75 ± 18

73 ± 25

54 ± 15b

54 ± 14b

SOFA score

12.5 ± 3.6

14.3 ± 1.4

12.4 ± 3.7

12.9 ± 2.9

12.1 ± 4.5

11.8 ± 2.8b

14.4 ± 4.4

13.4 ± 4.6

9.6 ± 4.2b

   Respiratory

2.5 ± 1.0

2.7 ± 0.9

2.5 ± 1.0

2.7 ± 0.9

2.1 ± 1.3

2.4 ± 0.6

2.6 ± 1.1

2.3 ± 1.5

2.2 ± 1.4

   Renal

2.4 ± 1.2

4.0 ± 0.0

2.3 ± 1.2b

2.1 ± 1.2b

2.5 ± 1.2b

2.5 ± 1.1b

2.8 ± 0.8a

2.1 ± 1.5b

1.9 ± 1.3b

   Hepatic

0.7 ± 1.0

0.3 ± 0.7

0.7 ± 1.0

0.3 ± 0.6

1.3 ± 1.2a

0.6 ± 0.8

0.6 ± 0.9

1.8 ± 1.7

0.9 ± 0.9

   Cardiovascular

3.3 ± 1.4

4.0 ± 0.0

3.3 ± 1.5

3.5 ± 1.3

3.2 ± 1.5

3.4 ± 1.5

4.0 ± 0.0

2.9 ± 1.8

2.1 ± 2.0a

   Hematologic

0.9 ± 1.2

0.5 ± 0.8

0.9 ± 1.2

0.6 ± 0.9

1.3 ± 1.4

0.3 ± 0.7

2.2 ± 1.6

2.6 ± 1.1

0.9 ± 1.2

   Neurologic

2.7 ± 1.4

2.8 ± 1.5

2.7 ± 1.4

3.7 ± 0.6a

1.7 ± 1.3a

2.8 ± 1.2

2.2 ± 1.3

1.8 ± 1.4b

1.6 ± 1.2

Lactate, mmol/L

11.6 ± 6.2

18.7 ± 5.3

11.2 ± 6.1b

12.8 ± 6.1b

8.7 ± 4.5b

10.9 ± 5.2b

8.6 ± 3.3b

13.5 ± 9.5b

10.8 ± 7.1b

pH

7.13 ± 0.19

6.75 ± 0.13

7.15 ± 0.17b

7.07 ± 0.19b

7.23 ± 0.09b

7.18 ± 0.14b

7.27 ± 0.04b

7.26 ± 0.07b

7.14 ± 0.18b

Bicarbonate, mmol/L

14.6 ± 5.9

4.4 ± 2.4

15.2 ± 5.6b

14.5 ± 5.6b

16.6 ± 5.8b

14.9 ± 4.0b

16.2 ± 1.8b

15.8 ± 5.7b

14.1 ± 8.8b

Creatinine, μmol/L

307 ± 265

796 ± 324

227 ± 141b

169 ± 128b

318 ± 181b

182 ± 48b

299 ± 125a

303 ± 122a

214 ± 57b

Survival

52 (26%)

5 (50%)

48 (26%)

19 (26%)

9 (21%)

9 (23%)

0

5 (38%)

6 (46%)

  1. Values are presented as mean ± standard deviation or as number (percentage). Comparison with metformin-associated lactic acidosis (MALA): aP < 0.05, bP < 0.01. Simplified Acute Physiology Score II (SAPS II) and Sequential Organ Failure Assessment (SOFA) score were measured on admission. Other causes of lactic acidosis were respiratory exhaustion (3), alcoholic lactic acidosis (3), acute liver failure (2), status epilepticus (2), anaphylactic shock, hypovolemic shock, and disseminated intravascular coagulation in acute myeloid leukemia. LAOO, lactic acidosis of other origin.