The role of serum lactate levels in predicting abdominal surgery in geriatric patients who had computed tomography

Kadir Kucukceran; Mustafa Kursat Ayrancı

doi:10.5472/marumj.957405

Research Article

The role of serum lactate levels in predicting abdominal surgery in geriatric patients who had computed tomography

Year 2021, Volume: 34 Issue: 3, 279 - 285, 27.10.2021

Kadir Kucukceran Mustafa Kursat Ayrancı

https://doi.org/10.5472/marumj.957405

Abstract

Objective: We investigated the importance of serum lactate levels in making decision regarding abdominal surgery in elderly patients
who underwent computed tomography.
Patients and Methods: Patients over 65 years of age who presented to the emergency department of a tertiary teaching hospital in
2019 were scanned within the hospital data processing system according to the criteria of tomography of the abdomen. Patients’
age, gender, lactate levels, the medical reason for their visit, pathological condition of abdominal computed tomography (aCT), a
recommendation of emergent surgery, mortality status, and length of stay in the hospital were collected. The patients were divided
into four groups according to surgery recommendation and pathologic status in aCT.
Results: Of the 356 patients who were included in the study, 194 (54.5%) were male. The mean age of the participants was 77.1±7.82
years, and their mean lactate level was 2.59±2.41 mmol/liter. Lactate values were statistically significant according to ROC analysis
that predict the state of surgery recommendation (AUC:0.796, p<0.001). There was a statistically significant difference in lactate
values between the groups (1.78±1.46, 3.19±2.71, 4.44±3.22, I-II p<0.001, I-III p<0.001, II-III p=0.002).
Conclusion: In geriatric patients, the aCT results and lactate levels were found to be reliable in deciding to eliminate abdominal
surgery.

Keywords

Geriatrics, Surgery, Lactates, Computed tomography, Emergency Department

References

1. Dündar ZD. Evaluation of geriatric patients admitted to emergency department with a complaint of abdominal pain in terms of demographic characteristics and prognosis. Selcuk Med J 2021;37:45-51. doi : 10.30733/std.2020.01374.
2. De Dombal F. Acute abdominal pain in the elderly. J Clin Gastroenterol 1994;19:331-5. doi: 10.1097/00004836-199412000-00016.
3. Foo CL, Chan KC, Goh HK, Seow E. Profiling acute presenting symptoms of geriatric patients attending an urban hospital emergency department. Ann Acad Med Singap 2009;38:515.
4. Spangler R, Van Pham T, Khoujah D, Martinez JP. Abdominal emergencies in the geriatric patient. Int J Emerg Med 2014;7:1-8. doi: 10.1186/s12245-014-0043-2.
5. Turrentine FE, Wang H, Simpson VB, Jones RS. Surgical risk factors, morbidity, and mortality in elderly patients. J Am Coll Surg 2006;203:865-77. doi: 10.1016/j.jamcollsurg.2006.08.026.
6. Juvonen P, Lehtimäki T, Eskelinen M, et al. The need for surgery in acute abdominal pain: a randomized study of abdominal computed tomography. In Vivo 2014;28:305-9.
7. Filiz AI, Aladag H, Akin ML, et al. The role of d-lactate in differential diagnosis of acute appendicitis. J Invest Surg 2010;23:218-23. doi: 10.3109/08941931003596877.
8. Isfordink C, Dekker D, Monkelbaan J. Clinical value of serum lactate measurement in diagnosing acute mesenteric ischaemia. Neth J Med 2018;76:60-4.
9. Verma I, Kaur S, Goyal S, Goyal S, Multani JS, Narang AP. Diagnostic value of lactate levels in acute abdomen disorders. Indian J Clin Biochem 2014;29:382-5. doi: 10.1007/s12291-013-0385-1.
10. Richards C, Ishihara K, Grayson C, Lustik M, Yheulon C. Serum lactate predicts resource utilization, but not surgical need, in the emergency department. J Surg Res 2018;226:89-93. doi: 10.1016/j.jss.2018.01.020.
11. Veličković J, Palibrk I, Miličić B, et al. The association of early postoperative lactate levels with morbidity after elective major abdominal surgery. Bosn J Basic Med Sci 2019;19:72-80. doi: 10.17305/bjbms.2018.3186.
12. Ravishankaran P, Shah AM, Bhat R. Correlation of interleukin-6, serum lactate, and C-reactive protein to inflammation, complication, and outcome during the surgical course of patients with acute abdomen. J Interferon Cytokine Res 2011;31:685-90. doi: 10.1089/jir.2011.0021.
13. Arenal JJ, Bengoechea-Beeby M. Mortality associated with emergency abdominal surgery in the elderly. Can J Surg 2003;46:111-6.
14. Rangel EL, Cooper Z, Olufajo OA, et al. Mortality after emergency surgery continues to rise after discharge in the elderly: predictors of 1-year mortality. J Trauma Acute Care Surg 2015;79:349-58. doi: 10.1097/TA.0000000000000773.
15. Brandt E, Tengberg LT, Bay-Nielsen M. Sarcopenia predicts 90-day mortality in elderly patients undergoing emergency abdominal surgery. Abdom Radiol (NY) 2019;44:1155-60. doi: 10.1007/s00261-018-1870-z.
16. Dundar ZD, Kocak S, Girisgin AS. Lactate and NEWS-L are fair predictors of mortality in critically ill geriatric emergency department patients. Am J Emerg Med 2020;38:217-221. doi: 10.1016/j.ajem.2019.02.006.
17. Shapiro NI, Howell MD, Talmor D, et al. Serum lactate as a predictor of mortality in emergency department patients with infection. Ann Emerg Med 2005;45:524-8. doi: 10.1016/j.annemergmed.2004.12.006.
18. del Portal DA, Shofer F, Mikkelsen ME, et al. Emergency department lactate is associated with mortality in older adults admitted with and without infections. Acad Emerg Med 2010;17:260-8. doi: 10.1111/j.1553-2712.2010.00681.x.
19. Joseph B, Zangbar B, Pandit V, et al. Emergency general surgery in the elderly: too old or too frail? J Am Coll Surg 2016;222:805-13. doi: 10.1016/j.jamcollsurg.2016.01.063.
20. Grundmann R, Petersen M, Lippert H, Meyer F. The acute (surgical) abdomen - epidemiology, diagnosis and general principles of management. Z Gastroenterol 2010;48:696-706. doi: 10.1055/s-0029-1245303.
21. Bugliosi TF, Meloy TD, Vukov LF. Acute abdominal pain in the elderly. Ann Emerg Med 1990;19:1383-6. doi: 10.1016/s0196-0644(05)82602-2.

Year 2021, Volume: 34 Issue: 3, 279 - 285, 27.10.2021

Kadir Kucukceran Mustafa Kursat Ayrancı

https://doi.org/10.5472/marumj.957405

Abstract

References

1. Dündar ZD. Evaluation of geriatric patients admitted to emergency department with a complaint of abdominal pain in terms of demographic characteristics and prognosis. Selcuk Med J 2021;37:45-51. doi : 10.30733/std.2020.01374.
2. De Dombal F. Acute abdominal pain in the elderly. J Clin Gastroenterol 1994;19:331-5. doi: 10.1097/00004836-199412000-00016.
3. Foo CL, Chan KC, Goh HK, Seow E. Profiling acute presenting symptoms of geriatric patients attending an urban hospital emergency department. Ann Acad Med Singap 2009;38:515.
4. Spangler R, Van Pham T, Khoujah D, Martinez JP. Abdominal emergencies in the geriatric patient. Int J Emerg Med 2014;7:1-8. doi: 10.1186/s12245-014-0043-2.
5. Turrentine FE, Wang H, Simpson VB, Jones RS. Surgical risk factors, morbidity, and mortality in elderly patients. J Am Coll Surg 2006;203:865-77. doi: 10.1016/j.jamcollsurg.2006.08.026.
6. Juvonen P, Lehtimäki T, Eskelinen M, et al. The need for surgery in acute abdominal pain: a randomized study of abdominal computed tomography. In Vivo 2014;28:305-9.
7. Filiz AI, Aladag H, Akin ML, et al. The role of d-lactate in differential diagnosis of acute appendicitis. J Invest Surg 2010;23:218-23. doi: 10.3109/08941931003596877.
8. Isfordink C, Dekker D, Monkelbaan J. Clinical value of serum lactate measurement in diagnosing acute mesenteric ischaemia. Neth J Med 2018;76:60-4.
9. Verma I, Kaur S, Goyal S, Goyal S, Multani JS, Narang AP. Diagnostic value of lactate levels in acute abdomen disorders. Indian J Clin Biochem 2014;29:382-5. doi: 10.1007/s12291-013-0385-1.
10. Richards C, Ishihara K, Grayson C, Lustik M, Yheulon C. Serum lactate predicts resource utilization, but not surgical need, in the emergency department. J Surg Res 2018;226:89-93. doi: 10.1016/j.jss.2018.01.020.
11. Veličković J, Palibrk I, Miličić B, et al. The association of early postoperative lactate levels with morbidity after elective major abdominal surgery. Bosn J Basic Med Sci 2019;19:72-80. doi: 10.17305/bjbms.2018.3186.
12. Ravishankaran P, Shah AM, Bhat R. Correlation of interleukin-6, serum lactate, and C-reactive protein to inflammation, complication, and outcome during the surgical course of patients with acute abdomen. J Interferon Cytokine Res 2011;31:685-90. doi: 10.1089/jir.2011.0021.
13. Arenal JJ, Bengoechea-Beeby M. Mortality associated with emergency abdominal surgery in the elderly. Can J Surg 2003;46:111-6.
14. Rangel EL, Cooper Z, Olufajo OA, et al. Mortality after emergency surgery continues to rise after discharge in the elderly: predictors of 1-year mortality. J Trauma Acute Care Surg 2015;79:349-58. doi: 10.1097/TA.0000000000000773.
15. Brandt E, Tengberg LT, Bay-Nielsen M. Sarcopenia predicts 90-day mortality in elderly patients undergoing emergency abdominal surgery. Abdom Radiol (NY) 2019;44:1155-60. doi: 10.1007/s00261-018-1870-z.
16. Dundar ZD, Kocak S, Girisgin AS. Lactate and NEWS-L are fair predictors of mortality in critically ill geriatric emergency department patients. Am J Emerg Med 2020;38:217-221. doi: 10.1016/j.ajem.2019.02.006.
17. Shapiro NI, Howell MD, Talmor D, et al. Serum lactate as a predictor of mortality in emergency department patients with infection. Ann Emerg Med 2005;45:524-8. doi: 10.1016/j.annemergmed.2004.12.006.
18. del Portal DA, Shofer F, Mikkelsen ME, et al. Emergency department lactate is associated with mortality in older adults admitted with and without infections. Acad Emerg Med 2010;17:260-8. doi: 10.1111/j.1553-2712.2010.00681.x.
19. Joseph B, Zangbar B, Pandit V, et al. Emergency general surgery in the elderly: too old or too frail? J Am Coll Surg 2016;222:805-13. doi: 10.1016/j.jamcollsurg.2016.01.063.
20. Grundmann R, Petersen M, Lippert H, Meyer F. The acute (surgical) abdomen - epidemiology, diagnosis and general principles of management. Z Gastroenterol 2010;48:696-706. doi: 10.1055/s-0029-1245303.
21. Bugliosi TF, Meloy TD, Vukov LF. Acute abdominal pain in the elderly. Ann Emerg Med 1990;19:1383-6. doi: 10.1016/s0196-0644(05)82602-2.

There are 21 citations in total.

Details

Primary Language	English
Subjects	Clinical Sciences
Journal Section	Original Articles
Authors	Kadir Kucukceran Mustafa Kursat Ayrancı This is me
Publication Date	October 27, 2021
Published in Issue	Year 2021 Volume: 34 Issue: 3

Cite

APA	Kucukceran, K., & Ayrancı, M. K. (2021). The role of serum lactate levels in predicting abdominal surgery in geriatric patients who had computed tomography. Marmara Medical Journal, 34(3), 279-285. https://doi.org/10.5472/marumj.957405
AMA	Kucukceran K, Ayrancı MK. The role of serum lactate levels in predicting abdominal surgery in geriatric patients who had computed tomography. Marmara Med J. October 2021;34(3):279-285. doi:10.5472/marumj.957405
Chicago	Kucukceran, Kadir, and Mustafa Kursat Ayrancı. “The Role of Serum Lactate Levels in Predicting Abdominal Surgery in Geriatric Patients Who Had Computed Tomography”. Marmara Medical Journal 34, no. 3 (October 2021): 279-85. https://doi.org/10.5472/marumj.957405.
EndNote	Kucukceran K, Ayrancı MK (October 1, 2021) The role of serum lactate levels in predicting abdominal surgery in geriatric patients who had computed tomography. Marmara Medical Journal 34 3 279–285.
IEEE	K. Kucukceran and M. K. Ayrancı, “The role of serum lactate levels in predicting abdominal surgery in geriatric patients who had computed tomography”, Marmara Med J, vol. 34, no. 3, pp. 279–285, 2021, doi: 10.5472/marumj.957405.
ISNAD	Kucukceran, Kadir - Ayrancı, Mustafa Kursat. “The Role of Serum Lactate Levels in Predicting Abdominal Surgery in Geriatric Patients Who Had Computed Tomography”. Marmara Medical Journal 34/3 (October 2021), 279-285. https://doi.org/10.5472/marumj.957405.
JAMA	Kucukceran K, Ayrancı MK. The role of serum lactate levels in predicting abdominal surgery in geriatric patients who had computed tomography. Marmara Med J. 2021;34:279–285.
MLA	Kucukceran, Kadir and Mustafa Kursat Ayrancı. “The Role of Serum Lactate Levels in Predicting Abdominal Surgery in Geriatric Patients Who Had Computed Tomography”. Marmara Medical Journal, vol. 34, no. 3, 2021, pp. 279-85, doi:10.5472/marumj.957405.
Vancouver	Kucukceran K, Ayrancı MK. The role of serum lactate levels in predicting abdominal surgery in geriatric patients who had computed tomography. Marmara Med J. 2021;34(3):279-85.

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