TY - JOUR
T1 - Association between intraoperative hyperlactatemia and myocardial injury after noncardiac surgery
AU - Kim, Jeayoun
AU - Park, Jungchan
AU - Kwon, Ji Hye
AU - Kim, Sojin
AU - Oh, Ah Ran
AU - Jang, Jae Ni
AU - Choi, Jin Ho
AU - Sung, Jidong
AU - Yang, Kwangmo
AU - Kim, Kyunga
AU - Ahn, Joonghyun
AU - Lee, Seung Hwa
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/9
Y1 - 2021/9
N2 - Background: Oxygen demand–supply mismatch is supposed to be one of the major causes of myocardial injuries after noncardiac surgery (MINS). Impaired tissue oxygenation during the surgery can lead to intraoperative hyperlactatemia. Therefore, we aimed to evaluate the relationship between intraoperative lactate level and MINS. Methods: A total of 1905 patients divided into groups according to intraoperative hyperlactatemia: 1444 patients (75.8%) into normal (≤2.2 mmol/L) and 461 patients (24.2%) into hyperlactatemia (>2.2 mmol/L) groups. The primary outcome was the incidence of MINS, and all-cause mortality within 30 days was compared. Results: In the crude population, the risks for MINS and 30-day mortality were higher for the hyperlactatemia group than the normal group (17.7% vs. 37.7%, odds ratio [OR]: 2.83, 95% confidence interval [CI]: 2.24–3.56, p < 0.001 and 0.8% vs. 4.8%, hazard ratio [HR]: 5.86, 95% CI: 2.9–12.84, p < 0.001, respectively). In 365 propensity score-matched pairs, intraoperative hyperlactatemia was consistently associated with MINS and 30-day mortality (21.6% vs. 31.8%, OR: 1.69, 95% CI: 1.21–1.36, p = 0.002 and 1.1% vs. 3.8%, HR: 3.55, 95% CI: 1.71–10.79, p < 0.03, respectively). Conclusion: Intraoperative lactate elevation was associated with a higher incidence of MINS and 30-day mortality.
AB - Background: Oxygen demand–supply mismatch is supposed to be one of the major causes of myocardial injuries after noncardiac surgery (MINS). Impaired tissue oxygenation during the surgery can lead to intraoperative hyperlactatemia. Therefore, we aimed to evaluate the relationship between intraoperative lactate level and MINS. Methods: A total of 1905 patients divided into groups according to intraoperative hyperlactatemia: 1444 patients (75.8%) into normal (≤2.2 mmol/L) and 461 patients (24.2%) into hyperlactatemia (>2.2 mmol/L) groups. The primary outcome was the incidence of MINS, and all-cause mortality within 30 days was compared. Results: In the crude population, the risks for MINS and 30-day mortality were higher for the hyperlactatemia group than the normal group (17.7% vs. 37.7%, odds ratio [OR]: 2.83, 95% confidence interval [CI]: 2.24–3.56, p < 0.001 and 0.8% vs. 4.8%, hazard ratio [HR]: 5.86, 95% CI: 2.9–12.84, p < 0.001, respectively). In 365 propensity score-matched pairs, intraoperative hyperlactatemia was consistently associated with MINS and 30-day mortality (21.6% vs. 31.8%, OR: 1.69, 95% CI: 1.21–1.36, p = 0.002 and 1.1% vs. 3.8%, HR: 3.55, 95% CI: 1.71–10.79, p < 0.03, respectively). Conclusion: Intraoperative lactate elevation was associated with a higher incidence of MINS and 30-day mortality.
KW - Cardiac troponin
KW - Lactate
KW - Myocardial injury after noncardiac surgery
KW - Noncardiac surgery
UR - https://www.scopus.com/pages/publications/85116592742
U2 - 10.3390/DIAGNOSTICS11091656
DO - 10.3390/DIAGNOSTICS11091656
M3 - Article
AN - SCOPUS:85116592742
SN - 2075-4418
VL - 11
JO - Diagnostics
JF - Diagnostics
IS - 9
M1 - 1656
ER -
