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Colegio de Medicina Interna de México.

2018, Number 1

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Med Int Mex 2018; 34 (1)

Serum lactate as predictive factor of mortality in upper digestive tract bleeding

Madrigal-Garibay JI, Lozada-Pérez CA, Melchor-López A, Vargas-Ayala G, Martínez-Nava GA

Language: Spanish
References: 16
Page: 38-45
PDF size: 255.97 Kb.


ABSTRACT

Background: According to Upper Gastrointestinal Bleeding of Gastroenterology Clinics of North America, in 2008 there were 863,000 hospital admissions for gastrointestinal bleeding, with reported mortality of 15-20%. In Mexico, mortality from upper digestive tract bleeding represents 8.5%, but increases up to 63% when it coexists with other diseases. Lactate has been validated for the prognosis of mortality in different areas.
Objective: To determine the usefulness of lactate as prognosis factor of mortality in upper digestive tract bleeding.
Material and Method: A retrospective, ambilective, observa- tional, analytical and unicenter cohort study was done measuring lactate in patients admitted for upper digestive tract bleeding at admission to the emergency room of Hospital General Xoco, Mexico City, from 2015 to 2016 later it was correlated with the diagnosis of discharge, seeking a correlation between upper digestive tract bleeding and discharge due to death. Lactate ratio and blood products transfused were evaluated as secondary objectives.
Results: There were included 30 patients. The mean lactate in men was 5.33 ± 0.53 mmol/L and in women were 1.2 ± 3.84 mmol/L with a p ‹ 0.01. The hospitalization time was 6.43 ± 5.13 days. The survival analysis was based on the mean lactate of 4.78; 29 patients graduated for improvement, while one patient died without finding a relation between lactate and death levels as a diagnosis of discharge; however, we did not find statistically significant relationship.
Conclusion: After analyzing our population we did not find a statistically significant relation between lactate levels at 4.78 mmol/L and mortality. We also looked for an association between lactate levels and complications during hospitalization; however, this either had significant relation. Despite of the obtained results, it is necessary to reconsider the study with a different approach adjusting the population characteristics and its size in order to obtain definitive data about this biomarker.


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