Blood Lactate Levels Intensive Care Patients Mortality Estimating, How much?

Yıl 2017, Cilt: 14 Sayı: 1, 12 - 28, 28.04.2017

Gülseda Dede Leyla Şahan Bahadır Dede Semra Demirbilek

Öz

Background: This study’s aim was to show the blood lactate levels how effective mortality prediction of
the patients hospitalized in the Intensive Care Unit.
Materials and Methods: After obtaining the approval of the relevant ethics committee files of 114 patients
hospitalized in Muğla Sıtkı Koçman University Intensive Care Unit in 2015 were analyzed retrospectively.
Results: The mean age of the 114 patients was 62.78±20.43 ; %59.6 was male and %40.4 was female.
The research group has an associated co-morbid disease in %75.4. The average length of stay of patients
was 10.85±13.17 per day and %31.6 patients were died. The mean age of study group, APACHE II score,
SOFA score, a statistically significant relationship between mortality and high lactate levels and pH were
found out ( P<0.05). In univariate analysis multivariate logistic regression models were found to
significantly influence and examined by association with mortality. . APACHE II score (≥23.50) [OR=37.00
(5.35 – 255.75)], SOFA score (≥5.50) [OR=12.50 (4.21 – 37.04)], lactate output value (≥1.75mmol)
[OR=7.59 (3.34 – 17.22)] and ages (≥65.00) [OR=5.36 (2.09 – 13.71)] have been found to increased the
risk of mortality.
Conclusion: The blood lactate value in determining the prognosis of patients is as important as scoring
systems used in intensive care. Lactate is a good parameter that can be used to estimate mortality.

Anahtar Kelimeler

Lactate, Mortality, Scoring system

Kan Laktat Seviyesi Yoğun Bakım Hastalarında Mortaliteyi Tahmin Etmede Ne Kadar Etkilidir?

Öz

Amaç: Bu çalışma ile Yoğun Bakım Ünitesinde yatan hastalarının mortalite tahmininde, kan laktat
değerlerinin ne kadar etkili olduğunu göstermek amaçlanmıştır.
Materyal ve Metod: Muğla Sıtkı Koçman Üniversitesi Anestezi Yoğun Bakım Ünitesinde 2015 yılında
yatan 114 hastanın dosyaları etik kurul onayı alındıktan sonra retrospektif olarak incelenmiştir. Hastaların
kayıtlı APACHE II, SOFA, giriş ve çıkış kan gazı analizleri değerlendirmeye alınmıştır.
Bulgular: Çalışmaya alınan 114 olgunun yaş ortalaması 62.78±20.43 olup; %59,6’sı erkek, %40,4’ü
kadındır. Araştırma grubunun %75,4’ünde eşlik eden bir yandaş hastalığı vardır. Hastaların ortalama yatış
süresi ortalama 10.85±13.17 gün olup, %31,6’sı exitus ile sonuçlanmıştır.
Araştırma grubunun yaş ortalaması, APACHE II skoru, SOFA skoru, laktat değeri ve çıkış pH değeri ile
mortalite arasında istatiksel olarak anlamlı derecede yüksek ilişki bulunmuştur (P<0.05). Araştırma
grubunda exitus olan olguların giriş ve çıkış kan değerleri arasındaki ilişkiye bakıldığında pH, laktat, HC03
değerleri ve APACHE II, SOFA skor ortalamalarıyla mortalite arasında istatiksel olarak anlamlı bir ilişki
bulunmuştur (P<0.05). Tek değişkenli analizlerde anlamlı bulunan değişkenler logistik regresyon modeline
alınmış ve mortalite ile ilişkisine göre etkisi incelendi. APACHE II skorunun (≥23.50) [OR=37.00 (5.35 –
255.75)], SOFA skorunun (≥5.50) [OR=12.50 (4.21 – 37.04)], çıkış laktat seviyesinin (≥1.75mmol) [OR=7.59 (3.34 – 17.22)] ve yaşın (≥65.00) [OR=5.36 (2.09 – 13.71)] mortalite riskini artırdığı
bulunmuştur.
Sonuç: Hastanın prognozunu belirlemede kan laktat değeri, yoğun bakımda kullanılan skorlama sistemleri
kadar önemlidir. Laktat mortalite tahmininde kullanılabilecek iyi bir parametredir.

Anahtar Kelimeler

Mortalite, Laktat, Skorlamalar

Kaynakça

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