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The significance of initial lactate levels in emergency department presentations of abdominal wall hernia

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Abstract

Introduction

Abdominal wall hernias are a frequent cause of abdominal pain-related emergency department visits. Our study aimed to establish the connection between lactate levels and patient outcomes in those with abdominal pain due to abdominal wall hernias.

Materials and methods

Our research followed a retrospective, observational, and descriptive approach and two center. We included patients who visited the emergency department for abdominal pain and were confirmed to have abdominal wall hernias through ultrasound.

Results

We enrolled 493 patients meeting the criteria. Median age was 65 years, with 54% (n = 266) being male. Regarding outcomes, 40.5% (n = 200) were hospitalized, 27.7% (n = 137) underwent surgery, and 7.9% (n = 39) underwent bowel resection. Mortality rate during hernia-related hospital admission was 0.6% (n = 3). For hospitalized patients, there were significant differences in white blood cell count, neutrophil count and percentage, platelet count, lymphocyte count, and percentage (p < 0.05). Patients undergoing resection showed significant differences in neutrophil count, neutrophil percentage, lymphocyte count, and lymphocyte percentage (p < 0.05). Lactate levels were statistically significant in all patient groups requiring hospitalization, surgery, and resection (p < 0.05). Sensitivity and specificity of lactate test results indicated in patients undergoing bowel resection, lactate values ≥1.96 mmol/L had a specificity of 64%, sensitivity of 71%, and a negative predictive value of 96% (p < 0.05).

Conclusion

Low lactate levels in patients presenting to the emergency department with abdominal pain caused by abdominal wall hernias have a high negative predictive value for excluding strangulation and the need for bowel resection. Therefore, we recommend the use of lactate as an additional diagnostic tool in emergency department presentations related to abdominal wall hernias.

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Data Avaiability

We presented the data as a supplementary document. Researchers who wish can use it by stating that it was taken from our study and with our permission.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Emergency Medicine Department, Ankara Etlik City Hospital, Ankara, Turkey

    N. İ. Işık, B. Katipoğlu, Ö. F. Turan, A. E. Gezer & M. Yazla

  2. General Surgery Department, Ankara Bilkent City Hospital, Ankara, Turkey

    A. A. Surel

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  1. N. İ. Işık
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  2. B. Katipoğlu
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  3. Ö. F. Turan
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  4. A. E. Gezer
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  5. M. Yazla
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Contributions

BK: protocol/project development, data collection and management, writing/editing; NİI: protocol/project development, writing/editing, data collection, manuscript reviewing; ÖFT: data analysis, manuscript reviewing; AEG: data collection. MY: statistic analyzed, literature review. AAS: Design, critical review, analyzed.

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Correspondence to N. İ. Işık.

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Ethical approval, Human and animal rights, and Informed consent

Ethics committee approval was stated in the material and method section. 'Ethical approval was obtained from the Institutional Review Board of Ankara Etlik City Hospital (Ethics Committee No: AEŞH-EK1-2023-256). '

Conflict of interests

None. Nurullah İshak Işık, Burak Katipoğlu, Ömer Faruk Turan, Adil Emre Gezer, Merve Yazla Ve Aziz Ahmet Surel declare that they have no conflict of interest. Our research has not been presented or published, in whole or in part, before.

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Işık, N.İ., Katipoğlu, B., Turan, Ö.F. et al. The significance of initial lactate levels in emergency department presentations of abdominal wall hernia. Hernia 28, 567–574 (2024). https://doi.org/10.1007/s10029-023-02950-5

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