Predictive Performance of Lactate as a Mortality Predictor in Patients with Acute Pancreatitis

Abstract

Objective: To investigate the relationship in the blood gas lactate levels and the prognosis of Emergency Department (ED) patients diagnosed with acute pancreatitis (AP). Study Design: Analytical study. Place and Duration of Study: Department of Emergency Medicine, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey between January 2018 and January 2020. Methodology: Hospital database was scanned according to the International Classification of Diseases (ICD) codes, and the relationship between lactate levels at admission and the 30-day mortality status of patients diagnosed with AP was analysed. The performance of lactate in predicting mortality was determined by receiver operating characteristic (ROC) analysis. In addition, the measurements such as the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the curve (AUC), and Youden J Index (YJI) were calculated. Results: There were 147 patients, with median age of 65 (50-76) years, where 91 were females (61.9%) and 56 were males (38.1%). The predictive values of lactate in terms of 30-day mortality were analysed by ROC analysis. Sensitivity (82.61%), specificity (79.84%), PPV (43.2%), NPV (96.1%), AUC (0.821), and YJI values (0.6245) were determined. Conclusion: Early recognition of patients with AP and initiation of appropriate treatment without delay will reduce morbidity and mortality. According to the conclusions, the lactate elevation measured at the time of admission can be used as a useful, fast and simple method in estimating mortality of AP patients.