Mortality Rate and Risk Factors Associated Mortality Outcome in Medical Critically Ill Patients with Severe Lactic Acidosis
Thanaphon Anutraungkool, MD1, Phitphiboon Deawtrakulchai, MD1,2
Affiliation : 1Division of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, 2Sub-Division of Critical Care Medicine, Division of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background: Blood lactic acid is converted to lactate, a biomarker of cellular hypoxia, which correlates with patient mortality. However, there is limited data available regarding the mechanisms of lactic acidosis and the factors associated with mortality in severe cases.
Objective: The present study aims to investigate the mortality rate among critically ill patients with severe lactic acidosis (more than 10 millimole/liter (mmol/L)) and associated factors.
Materials and Methods: A retrospective descriptive study involving 285 critically ill patients aged over 18 years, who were admitted to Srinagarind Hospital. The present study period extended from June 2018 to December 2021.
Results: A total of 285 critically ill patients with severe lactic acidosis were included, comprising 57.19% males, with a median age of 62 years (interquartile range [IQR] 52 to 72). The median baseline and maximum lactic acid levels were 12.40 (10.90 to 15.40) and 17 (12.20 to 23.30) mmol/L, respectively. The median baseline acidity [pH] was 7.20 (7.09 to 7.26). Septic shock was identified as the leading cause of severe lactic acidosis in 65.96% of cases. There were 216 in-hospital deaths, resulting in a mortality rate of 76.14%. Independent factors associated with mortality were cardiogenic shock (adjusted odds ratio [AOR]=5.53, p=0.03, 95% CI 1.15 to 26.63) and acute hepatitis (AOR=2.66, p=0.03, 95% CI 1.11 to 6.41).
Conclusion: Severe lactic acidosis has a very high in-hospital mortality rate, with cardiogenic shock and acute hepatitis identified as independent factors associated with mortality.
Keywords : Severe lactic acidosis; Mortality; Critically ill patients; Related factors
