Flores-Mendoza JF, Velarde-Ruiz VJA, Aldana-Ledesma JM, Morel-Cerda EC, Díaz-Aceves PE, Alonzo-García CJ, Mercado-Jauregui LA, López-Cota GA, Cruz-Mirana AL, Marfil-Garza BJ

Language: Spanish
References: 11
Page: 76-83
PDF size: 605.43 Kb.

ABSTRACT

Introduction. Acute Liver Failure (ACLF) is a syndrome with an acute decompensation of a liver chronic disease associated to organic failure, and shortterm mortality. (1). 13 definitions for the diagnosis of the syndrome have been proposed. (2) In México there is no consensus concerning which definition is better to diagnose the disease and the variables from the proposed scales that have a higher association to short-term mortality. Besides the organic failure, it is necessary to look for other variables associated to mortality on this type of patients. The objective of this study is to assess the association of hyperlactatemia (Serum Lactate ≥2 mmol/L) and mortality on patients with ACLF.
Material and Methods. An observational, descriptive, cross-sectional, retrospective study regarding a series of clinical cases was done. 55 patients with ACLF were assessed, grouped into two, with Hyperlactatemia (n=35) Lactate ≥ 2 mmol/L) and with no Hyperlactatemia (n=20).The variables studied were: organic failure, encephalopathy, coagulopathy, kidney failure, liver failure, circulatory failure, need for pressors, and their relation to mortality. Also, the prognosis performance was researched with the primary outcome, and a prediction clinical model was developed.
Results. The levels of lactate ≥ 2 mmol/L were associated to a higher risk of mortality. (RR 4.57, IC 95% 1.57-13.29). After adjusting the variables to the multivariate analysis of the Child-Pugh, triggers, and number of organic failures) this variable kept being statistically related to a higher risk of death (OR 10.715, IC 95%, 1.343-85.489). Finally, there elevated Lactate levels had a sensitivity of 88.9% (IC 95% 70.8-97.6), a specificity of 60.7% (IC 95% 40.9-78.5), with an area under the curve of 0.75 (IC 95% 0.62-0.88) for the prediction of death.
Discussion. There is an association between the hyperlactatemia and mortality on patients with ACLF.

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