The Effect of Blood Lactate Level on Prognosis in Patients with Hemorrhagic and Ischemic Cerebrovascular Disease

Öz

The aim of our study is to investigate the relationship between venous blood lactate levels and prognosis in ischemic and hemorrhagic stroke patients. Patients over 18 years of age who applied to Eskişehir Osmangazi Univesrsity Faculty of Medicine emergency service and diagnosed with ischemic or hemorrhagic stroke for less than 12 hours were included in our study. The demographic information of the patients, initial and 24th hour venous blood lactate levels and National Institutes of Health Stroke Scale (NIHSS), Computed Tomography (CT) findings and 3rd month modified Rankin scale (mRs) were recorded and the relationship between them was evaluated. A total of 88 patients, 51 (58%) male, 72 (81.8%) diagnosed with ischemic stroke, were included in the study. In 7 (8%) patients diagnosed with ischemic stroke, the infarct area larger than 2/3 was seen on CT. The median values of venous blood lactate levels at admission and 24 hours were 1.6 mmol / L, 1.4 mmol / L, respectively and the decrease was statistically significant (0-24 Hours p = 0.019, p <0.001). In patients with ischemic stroke, the first venous blood lactate level was higher in those with infarct size greater than 2/3 of the MCA irrigation area compared to the smaller ones (p = 0.013). In hemorrhagic strokes, initial venous blood lactate levels were higher than in ischemic stroke (2.05 vs 1.55 mmol / l, p = 0.043). No significant correlation was found between NIHSS and mRs with lactate levels at admission and 24 hours. Measurement of venous blood lactate level in stroke patients can assist emergency physicians in determining the type of bleeding and the size of the ischemic infarct site and in stroke management.

Anahtar Kelimeler

• Stroke, lactate, NIHSS, mRs

Hemorajik Ve İskemik Serebrovasküler Hastalık Tanısı Alan Hastalarda Kan Laktat Düzeyinin Prognoz Üzerine Etkisi

Öz

Çalışmamızın amacı iskemik ve hemorajik inme tanısı alan hastalarda, venöz kan laktat değerinin prognoz üzerine etkisinin araştırılmasıdır. Çalışmamıza, (Eskişehir Osmangazi Üniversitesi Tıp Fakültesi cil servisine başvuran ve 12 saatten kısa süreli iskemik veya hemorajik inme tanısı alan 18 yaş üstü hastalar dahil edildi. Hastaların demografik bilgileri, ilk başvuru ve 24. saat venöz kan laktat düzeyleri ve) National Institutes of Health Stroke Scale (NIHSS), bilgisayarlı tomografi (BT) bulguları ve 3. ay modifiye Ranson skalası (mRs) kayıt edildi ve aralarındaki ilişki değerlendirildi. Çalışmaya 51’i (%58) erkek, 72’si (%81,8) iskemik, inme tanısı alan toplam 88 hasta dahil edildi. İskemik inme tanısı alan 7 (%8) hastada infarkt alanı 2/3’den büyük olduğu çekilen BT'de görüldü. Başvuru ve 24. saat venöz kan laktat düzeyleri medyan değerleri sırasıyla: 1,6 mmol/L, 1,4 mmol/l ve azalma istatistiksel olarak anlamlı idi (0-24 Saat p=0,019, p<0,001). İskemik inmeli hastalarda ilk venöz kan laktat düzeyi, infarkt alanı büyüklüğü MCA sulama alanının 2/3’ünden büyük olanların, küçük olanlara göre daha yüksek idi (p=0,013). Hemorajik inmelerde ise ilk başvuru venöz kan laktat düzeylerinin iskemik inmeye göre daha yüksek idi (2.05 e karşı 1,55 mmol/l, p=0,043). Başvuru ve 24. saat laktat düzeyleri ile NIHSS ve mRs arasında anlamlı ilişki tespit edilemedi. İnme hastalarında venöz kan laktat düzeyi ölçümü, kanama tipi ve iskemik infarkt alanı büyüklüğünün belirlenmesinde ve inme yönetiminde acil tıp hekimlerine yardımcı olabilir.

Anahtar Kelimeler

• inme
• laktat
• venöz
• prognoz
• iskemik
• kanama

Kaynakça

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