Serum Lactate Concentration on Admission to Hospital Predicts the Postoperative Mortality of Elderly Patients with Hip Fractures 30 Days After Surgery

Overview

Journal Am J Transl Res

Specialty General Medicine

Date 2021 Oct 15

PMID 34650704

Citations 2

Authors

Xiaobin Chen

Jianzheng Zhang

Yang Zhang

Yiyun Lin

Zhi Liu

Xiaowei Wang

Tiansheng Sun

Affiliations

Soon will be listed here.

Abstract

Purpose: To determine whether serum lactate concentration on admission to hospital is a predictor for 30-day and 1-year mortality for patients who underwent hip-surgery.

Methods: Data from elderly patients with hip fractures admitted to our hospital (Jan 2012-Dec 2016) were reviewed. The lactate concentration on admission was assessed using a cut-off value of 2.0 mmol/L and then a new cut-off value was determined by maximizing the Youden index. Multivariate logistic regression was employed to verify whether a higher lactate concentration compared with the cutoff value was an independent risk factor for postoperative mortality after 30 days or at 1 year.

Results: A total of 1,004 patients were enrolled. There were differences in the incidence of postoperative complications (28.6% 21.9%, =0.022), length of stay (13.56±8.66 12.47±7.81 days, =0.047), 30-day mortality (10.8% 1.3%, <0.001), 1-year mortality (23.3% 11.8%, <0.001) and survival time (23.92±16.58 28.81±16.54 months, <0.001) between the ≥2.0 mmol/L (n=315) and <2 mmol/L (n=689) groups. Serum lactate concentration was a good predictor of 30-day mortality (AUC=0.829, <0.001) with a cutoff value of lactate =2.35 mmol/L (sensitivity =0.744, specificity =0.834). Multivariate analysis revealed that a serum lactate concentration ≥2.35 mmol/L at admission was an independent risk factor for 30-day (OR=9.93, <0.001) and 1-year (OR=2.23, <0.001) mortality.

Conclusion: The admission lactate concentration (≥2.35 mmol/L) following hip fracture derived by this study was a significant predictor of mortality 30 days after surgery, which might help physicians to stratify the risk for these patients.

Citing Articles

Association of Serum Lactate Levels Measured in the Emergency Department with 30-Day Mortality in Older Patients with Unilateral Hip Fractures.

Ozen Olcay H, Emektar E, Saral Ozturk Z, Akkan S, Cevik Y Ann Geriatr Med Res. 2024; 28(3):301-306.

PMID: 38952335 PMC: 11467522. DOI: 10.4235/agmr.24.0011.

Pilot Project for a Web-Based Dynamic Nomogram to Predict Survival 1 Year After Hip Fracture Surgery: Retrospective Observational Study.

McLeod G, Kennedy I, Simpson E, Joss J, Goldmann K Interact J Med Res. 2022; 11(1):e34096.

PMID: 35238320 PMC: 9008534. DOI: 10.2196/34096.

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