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Serum Lactate Is an Indicator for Short-Term and Long-Term Mortality in Patients with Acute Pancreatitis

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Abstract

Background

Serum lactate, as a single and an easily available biomarker, has been applied in various diseases.

Aims

In this study, we aimed to explore the predictive value of serum lactate for short-term and long-term prognosis in acute pancreatitis (AP) admitted in intensive care unit (ICU) based on a large-scale database.

Methods

AP patients admitted in ICU in the MIMIC-IV database were included. We constructed three different models to investigate the relationships between serum lactate and clinical outcomes, including 30-day, 180-day and 1-year mortality in AP. Smooth fitting curves were performed for intuitively demonstrating the relationship between serum lactate and different outcomes in AP by the generalized additive model.

Results

A total of 895 AP patients admitted in ICU were included. The mortalities of 30 days, 180 days, and 1 year were 12.63% (n = 113), 16.87% (n = 151), and 17.54% (n = 157). In model B, with 1-mmol/L increment in serum lactate, the values of OR in 30-day, 180-day and 1-year mortality were 1.20 (95%CI 1.04–1.37, P = 0.0094), 1.21 (95%CI 1.06–1.37, P = 0.0039), and 1.21 (95%CI 1.07–1.38, P = 0.0035). The AUCs of serum lactate for predicting 30-day, 180-day, and 1-year mortality in AP were 0.688 (95%CI 0.633–0.743), 0.655 (95%CI 0.605–0.705), and 0.653 (95%CI 0.603–0.701), respectively. The cut-off value of serum lactate predicting 30-day, 180-day and 1-year mortality in AP was 2.4 mmol/L.

Conclusion

Serum lactate could be an indicator for short-term and long-term mortality in patients with AP admitted in ICU.

Graphical Abstract

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Data availability

The data that support the findings of this study are available from the Massachusetts Institute of Technology (MIT) and Beth Israel Deaconess Medical Center (BIDMC) but restrictions apply to the availability of these data, which were used under license for the current study and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of the Massachusetts Institute of Technology (MIT) and Beth Israel Deaconess Medical Center (BIDMC).

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Acknowledgments

None.

Funding

Changsha science and technology Bureau (Nos. kzd21084, kq2004162). Changsha Central Hospital (Nos. YNKY202306; YNKY202115). Changsha Natural Science Foundation (No. kq2208445). Hunan Province Natural Science Foundation (Nos. 2021JJ3075, 2023JJ60402).

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Author notes

  1. Zhao Zeng, Rong Huang, Hang Lin, and Ju Luo have contributed equally to this article.

Authors and Affiliations

  1. Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, No. 161 Shaoshan South Road, Changsha, 410004, Hunan, China

    Zhao Zeng, Rong Huang, Hang Lin & Ning Ding

  2. Department of Orthopedics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China

    Hongchun Peng

  3. Department of Geriatrics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China

    Ju Luo

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  1. Zhao Zeng
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Contributions

Conception and design: Hongchun Peng, Ju Luo, and Ning Ding. Administrative support: Ning Ding, Rong Huang, and Hang Lin. Provision of study materials or patients: Ning Ding and Ju Luo. Collection and assembly of data: Rong Huang and Zhao Zeng. Data analysis and interpretation: Hang Lin and Ning Ding. Manuscript writing: Ning Ding. Final approval of manuscript: All authors.

Corresponding author

Correspondence to Ning Ding.

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Competing interests

The authors declare that they have no competing interests.

Ethical approval and consent to participate

This study was conducted in accordance with Good Clinical Practice (Declaration of Helsinki 2002). MIMIC-IV was an anonymized public database. To apply for access to the database, we passed the Protecting Human Research Participants exam (No.32900964). The project was approved by the institutional review boards of the Massachusetts Institute of Technology (MIT) and Beth Israel Deaconess Medical Center (BIDMC) and was given a waiver of informed consent.

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Zeng, Z., Huang, R., Lin, H. et al. Serum Lactate Is an Indicator for Short-Term and Long-Term Mortality in Patients with Acute Pancreatitis. Dig Dis Sci (2024). https://doi.org/10.1007/s10620-024-08419-4

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