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Early lactate clearance for predicting outcomes in patients with gastrointestinal bleeding
- Title
- Early lactate clearance for predicting outcomes in patients with gastrointestinal bleeding
- Authors
- Kim K.; Lee D.H.; Choi Y.H.; Bae S.J.
- Ewha Authors
- 최윤희; 이덕희; 김건
- SCOPUS Author ID
- 최윤희; 이덕희; 김건
- Issue Date
- 2023
- Journal Title
- Irish Journal of Medical Science
- ISSN
- 2112-1265
- Citation
- Irish Journal of Medical Science vol. 192, no. 4, pp. 1923 - 1929
- Keywords
- Emergency department; Gastrointestinal hemorrhage; In-hospital mortality; Lactate
- Publisher
- Springer Science and Business Media Deutschland GmbH
- Indexed
- SCOPUS
- Document Type
- Article
- Abstract
- Background: Acute gastrointestinal bleeding (GI bleeding) can range from mild symptoms to life-threatening conditions that require emergency intervention. Therefore, it is important to first identify the high-risk and low-risk patients in the emergency department (ED). Aims: This study aimed to investigate the usefulness of a three-hourly interval for determining the lactate clearance, which is shorter than the time interval in previous studies, in order to predict the prognosis early in patients with GI bleeding. Methods: This retrospective study involved patients who visited for complaining of GI bleeding symptoms. Initial lactate levels were measured upon arrival at the ED and measured again 3 h later after performing initial resuscitation. And 3-h lactate clearance was calculated. Lactate and 3-h lactate clearance for predicting outcomes were evaluated by the area under the receiver operating characteristic (AUROC) curve. Results: A total of 104 patients were enrolled and 21 patients (20.2%) died in the hospital. Multivariate logistic regression showed that 3-h lactate clearance was a significant predictor of in-hospital mortality. The AUROC of 3-h lactate clearance for predicting in-hospital mortality was 0.756. The sensitivity and specificity were 66.67% and 75.90%. On combining lactate clearance, total bilirubin, and PTT, the AUROC was 0.899 for predicting in-hospital mortality. Conclusions: This study validated that lactate clearance at three-hourly intervals is useful for early prediction of mortality and prognosis in patients with GI bleeding. It is important to perform not only an initial lactate measurement, but also a follow-up lactate measurement after initial resuscitation to check the lactate clearance. © 2022, The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.
- DOI
- 10.1007/s11845-022-03185-6
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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