Postoperative arterial blood lactate level as a mortality marker in patients with colorectal perforation

Purpose This study aims to assess the clinical relevance of postoperative arterial blood lactate (LAC) level as a prognostic factor in patients with colorectal perforation. Methods Forty-two patients (22 males, 20 females; mean age, 70.8 years) underwent emergency surgery for colorectal perforation....

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Bibliographic Details
Published in:International journal of colorectal disease 2014-01, Vol.29 (1), p.51-55
Main Authors: Shimazaki, Jiro, Motohashi, Gyo, Nishida, Kiyotaka, Ubukata, Hideyuki, Tabuchi, Takafumi
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Analysis
Arteries - metabolism
Biomarkers - blood
Blood cell count
C-reactive protein
Female
Gastroenterology
Hepatology
Humans
Internal Medicine
Intestinal Perforation - blood
Intestinal Perforation - mortality
Lactates
Lactates - blood
Male
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Middle Aged
Mortality
Multivariate Analysis
Original
Original Article
Physiological aspects
Postoperative Period
Preoperative Care
Proctology
Regression Analysis
Risk Factors
Surgery
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Summary:Purpose This study aims to assess the clinical relevance of postoperative arterial blood lactate (LAC) level as a prognostic factor in patients with colorectal perforation. Methods Forty-two patients (22 males, 20 females; mean age, 70.8 years) underwent emergency surgery for colorectal perforation. The patients were divided into mortality and survivor groups. As a prognostic scoring system, Acute Physiological and Chronic Health Evaluation II (APACHE-II), Sequential Organ Failure Assessment (SOFA), and Systemic Inflammatory Response Syndrome criteria were calculated. These scores, postoperative LAC level, and other data, including site and etiology of perforation, elapsed time from onset to surgery (eTIME), preoperative white blood cell (WBC) and platelet counts, preoperative C-reactive protein (CRP), and preoperative arterial blood base excess were assessed between the groups. Results The total mortality rate was 33.3 %. On univariate analysis, the APACHE-II and SOFA scores were significantly higher, and eTIME was significantly longer in the mortality group than in the survivor group. The postoperative LAC level was significantly higher in the mortality group (43.1 ± 14.1 mg/dl) than in the survivor group (23.8 ± 12.7 mg/dl; p  
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-013-1738-1