Elevated Lactate Dehydrogenase Predicts Pneumonia in Spontaneous Intracerebral Hemorrhage

Overview

Journal Heliyon

Specialty Social Sciences

Date 2024 Feb 26

PMID 38404841

Authors

Yangchun Xiao

Shuanghong He

Xin Cheng

Liyuan Peng

Yixin Tian

Tiangui Li

Jialing He

Pengfei Hao

Weelic Chong

Yang Hai

Chao You

Fang Fang

Zongjun Peng

Yu Zhang

Affiliations

Soon will be listed here.

Abstract

Background: Although a variety of risk factors for pneumonia after spontaneous intracerebral hemorrhage have been established, an objective and easily obtainable predictor is still needed. Lactate dehydrogenase is a nonspecific inflammatory biomarker. In this study, we aimed to assess the association between lactate dehydrogenase and pneumonia in spontaneous intracerebral hemorrhage patients.

Methods: Our study was a retrospective, multicenter cohort study, undertaken in 7562 patients diagnosed with spontaneous intracerebral hemorrhage from 3 hospitals. All serum Lactate dehydrogenase was collected within 7 days from admission and divided into four groups as quartile(Q). We conducted a multivariable logistic regression analysis to assess the association of Lactate dehydrogenase with pneumonia.

Results: Among a total of 7562 patients, 2971 (39.3%) patients were diagnosed with pneumonia. All grades of elevated lactate dehydrogenase were associated with increased raw and risk-adjusted risk of pneumonia. Multiple logistic regression analysis showed odds ratios for Q2-Q4 compared with Q1 were 1.21 (95% CI, 1.04-1.42), 1.64(95% CI, 1.41-1.92), and 1.92 (95% CI, 1.63-2.25) respectively. The odds ratio after adjustment was 4.42 (95% CI, 2.94-6.64) when lactate dehydrogenase was a continuous variable after log-transformed.

Conclusions: Elevated lactate dehydrogenase is significantly associated with an increase in the odds of pneumonia and has a predictive value for severe pneumonia in patients with pneumonia. Lactate dehydrogenase may be used to predict pneumonia events in spontaneous intracerebral hemorrhage patients as a laboratory marker.

Citing Articles

Rat models of postintracerebral hemorrhage pneumonia induced by nasal inoculation with or intratracheal inoculation with LPS.

Wang R, Gan C, Mao R, Chen Y, Yan R, Li G Front Immunol. 2025; 15():1477902.

PMID: 39845950 PMC: 11750689. DOI: 10.3389/fimmu.2024.1477902.

References

Fine M, Auble T, Yealy D, Hanusa B, Weissfeld L, Singer D . A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997; 336(4):243-50. DOI: 10.1056/NEJM199701233360402. View

Chen W, Zhong K, Guan Y, Zhang H, Zhang H, Pan T . Evaluation of the significance of interleukin-6 in the diagnosis of postoperative pneumonia: a prospective study. BMC Cardiovasc Disord. 2022; 22(1):306. PMC: 9261039. DOI: 10.1186/s12872-022-02744-0. View

Gaspar P, Al-Bayati F, Andrew P, Neves A, Yesilkaya H . Lactate dehydrogenase is the key enzyme for pneumococcal pyruvate metabolism and pneumococcal survival in blood. Infect Immun. 2014; 82(12):5099-109. PMC: 4249287. DOI: 10.1128/IAI.02005-14. View

Luna C, Perin M . Can lactate dehydrogenase (LDH) be used as a marker of severity of pneumonia in patients with renal transplant?. Ann Transl Med. 2020; 8(15):911. PMC: 7475410. DOI: 10.21037/atm-2020-34. View

Kishore A, Vail A, Chamorro A, Garau J, Hopkins S, Di Napoli M . How is pneumonia diagnosed in clinical stroke research? A systematic review and meta-analysis. Stroke. 2015; 46(5):1202-9. DOI: 10.1161/STROKEAHA.114.007843. View

Rae N, Chalmers J . Antibiotic prophylaxis is ineffective in preventing pneumonia post-stroke. J R Coll Physicians Edinb. 2016; 45(4):276-7. DOI: 10.4997/JRCPE.2015.405. View

Yan D, Huang Q, Dai C, Ren W, Chen S . Lactic Dehydrogenase to Albumin Ratio Is Associated With the Risk of Stroke-Associated Pneumonia in Patients With Acute Ischemic Stroke. Front Nutr. 2021; 8:743216. PMC: 8481374. DOI: 10.3389/fnut.2021.743216. View

Yu S, Xu L, Qi Q, Geng Y, Chen H, Meng Z . Serum lactate dehydrogenase predicts prognosis and correlates with systemic inflammatory response in patients with advanced pancreatic cancer after gemcitabine-based chemotherapy. Sci Rep. 2017; 7:45194. PMC: 5366928. DOI: 10.1038/srep45194. View

Ding C, Peng L, Lin Y, Yu L, Wang D, Kang D . Elevated Lactate Dehydrogenase Level Predicts Postoperative Pneumonia in Patients with Aneurysmal Subarachnoid Hemorrhage. World Neurosurg. 2019; 129:e821-e830. DOI: 10.1016/j.wneu.2019.06.041. View

10.

Hillas G, Vassilakopoulos T, Plantza P, Rasidakis A, Bakakos P . C-reactive protein and procalcitonin as predictors of survival and septic shock in ventilator-associated pneumonia. Eur Respir J. 2009; 35(4):805-11. DOI: 10.1183/09031936.00051309. View

11.

Sun R, Lv D, Xiao M, Zhang L, Xu J, Yu X . Diagnostic accuracy of the 1,3-beta-D-glucan test and lactate dehydrogenase for pneumocystis pneumonia in non-HIV patients. Sci Rep. 2021; 11(1):9226. PMC: 8085008. DOI: 10.1038/s41598-021-88729-z. View

12.

Vermeij J, Westendorp W, Dippel D, van de Beek D, Nederkoorn P . Antibiotic therapy for preventing infections in people with acute stroke. Cochrane Database Syst Rev. 2018; 1:CD008530. PMC: 6491314. DOI: 10.1002/14651858.CD008530.pub3. View

13.

Drent M, Cobben N, Henderson R, Wouters E, Van Dieijen-Visser M . Usefulness of lactate dehydrogenase and its isoenzymes as indicators of lung damage or inflammation. Eur Respir J. 1996; 9(8):1736-42. DOI: 10.1183/09031936.96.09081736. View

14.

Wang C, Zhang Y, Wang J, Zhang X, Pan Z, Chen L . Association Between Serum Lactate Dehydrogenase Level and Hematoma Expansion in Patients with Primary Intracerebral Hemorrhage: A Propensity-Matched Analysis. World Neurosurg. 2022; 160:e579-e590. DOI: 10.1016/j.wneu.2022.01.080. View

15.

Su Y, Ju M, Ma J, Tu G, He H, Gu Z . Lactate dehydrogenase as a prognostic marker of renal transplant recipients with severe community-acquired pneumonia: a 10-year retrospective study. Ann Transl Med. 2020; 7(22):660. PMC: 6944597. DOI: 10.21037/atm.2019.10.75. View

16.

Kojima K, Yoon H, Okishio K, Tsuyuguchi K . Increased lactate dehydrogenase reflects the progression of COVID-19 pneumonia on chest computed tomography and predicts subsequent severe disease. Sci Rep. 2023; 13(1):1012. PMC: 9848045. DOI: 10.1038/s41598-023-28201-2. View

17.

Nzwalo H, Nogueira J, Felix A, Guilherme P, Abreu P, Figueiredo T . Short-Term Outcome of Spontaneous Intracerebral Hemorrhage in Algarve, Portugal: Retrospective Hospital-Based Study. J Stroke Cerebrovasc Dis. 2017; 27(2):346-351. DOI: 10.1016/j.jstrokecerebrovasdis.2017.09.006. View

18.

Kawamata R, Yokoyama K, Sato M, Goto M, Nozaki Y, Takagi T . Utility of serum ferritin and lactate dehydrogenase as surrogate markers for steroid therapy for Mycoplasma pneumoniae pneumonia. J Infect Chemother. 2015; 21(11):783-9. DOI: 10.1016/j.jiac.2015.07.009. View

19.

Quist J, Hill A . Serum lactate dehydrogenase (LDH) in Pneumocystis carinii pneumonia, tuberculosis, and bacterial pneumonia. Chest. 1995; 108(2):415-8. DOI: 10.1378/chest.108.2.415. View

20.

Hariyanto T, Japar K, Kwenandar F, Damay V, Siregar J, Lugito N . Inflammatory and hematologic markers as predictors of severe outcomes in COVID-19 infection: A systematic review and meta-analysis. Am J Emerg Med. 2021; 41:110-119. PMC: 7831442. DOI: 10.1016/j.ajem.2020.12.076. View