Cargando…

Association between Intraoperative Hyperlactatemia and Myocardial Injury after Noncardiac Surgery

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 intraoperati...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Jeayoun, Park, Jungchan, Kwon, Ji-Hye, Kim, Sojin, Oh, Ah Ran, Jang, Jae Ni, Choi, Jin-Ho, Sung, Jidong, Yang, Kwangmo, Kim, Kyunga, Ahn, Joonghyun, Lee, Seung-Hwa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8465750/
https://www.ncbi.nlm.nih.gov/pubmed/34573997
http://dx.doi.org/10.3390/diagnostics11091656
_version_ 1784572956270133248
author Kim, Jeayoun
Park, Jungchan
Kwon, Ji-Hye
Kim, Sojin
Oh, Ah Ran
Jang, Jae Ni
Choi, Jin-Ho
Sung, Jidong
Yang, Kwangmo
Kim, Kyunga
Ahn, Joonghyun
Lee, Seung-Hwa
author_facet Kim, Jeayoun
Park, Jungchan
Kwon, Ji-Hye
Kim, Sojin
Oh, Ah Ran
Jang, Jae Ni
Choi, Jin-Ho
Sung, Jidong
Yang, Kwangmo
Kim, Kyunga
Ahn, Joonghyun
Lee, Seung-Hwa
author_sort Kim, Jeayoun
collection PubMed
description 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.
format Online
Article
Text
id pubmed-8465750
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-84657502021-09-27 Association between Intraoperative Hyperlactatemia and Myocardial Injury after Noncardiac Surgery Kim, Jeayoun Park, Jungchan Kwon, Ji-Hye Kim, Sojin Oh, Ah Ran Jang, Jae Ni Choi, Jin-Ho Sung, Jidong Yang, Kwangmo Kim, Kyunga Ahn, Joonghyun Lee, Seung-Hwa Diagnostics (Basel) Article 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. MDPI 2021-09-09 /pmc/articles/PMC8465750/ /pubmed/34573997 http://dx.doi.org/10.3390/diagnostics11091656 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Jeayoun
Park, Jungchan
Kwon, Ji-Hye
Kim, Sojin
Oh, Ah Ran
Jang, Jae Ni
Choi, Jin-Ho
Sung, Jidong
Yang, Kwangmo
Kim, Kyunga
Ahn, Joonghyun
Lee, Seung-Hwa
Association between Intraoperative Hyperlactatemia and Myocardial Injury after Noncardiac Surgery
title Association between Intraoperative Hyperlactatemia and Myocardial Injury after Noncardiac Surgery
title_full Association between Intraoperative Hyperlactatemia and Myocardial Injury after Noncardiac Surgery
title_fullStr Association between Intraoperative Hyperlactatemia and Myocardial Injury after Noncardiac Surgery
title_full_unstemmed Association between Intraoperative Hyperlactatemia and Myocardial Injury after Noncardiac Surgery
title_short Association between Intraoperative Hyperlactatemia and Myocardial Injury after Noncardiac Surgery
title_sort association between intraoperative hyperlactatemia and myocardial injury after noncardiac surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8465750/
https://www.ncbi.nlm.nih.gov/pubmed/34573997
http://dx.doi.org/10.3390/diagnostics11091656
work_keys_str_mv AT kimjeayoun associationbetweenintraoperativehyperlactatemiaandmyocardialinjuryafternoncardiacsurgery
AT parkjungchan associationbetweenintraoperativehyperlactatemiaandmyocardialinjuryafternoncardiacsurgery
AT kwonjihye associationbetweenintraoperativehyperlactatemiaandmyocardialinjuryafternoncardiacsurgery
AT kimsojin associationbetweenintraoperativehyperlactatemiaandmyocardialinjuryafternoncardiacsurgery
AT ohahran associationbetweenintraoperativehyperlactatemiaandmyocardialinjuryafternoncardiacsurgery
AT jangjaeni associationbetweenintraoperativehyperlactatemiaandmyocardialinjuryafternoncardiacsurgery
AT choijinho associationbetweenintraoperativehyperlactatemiaandmyocardialinjuryafternoncardiacsurgery
AT sungjidong associationbetweenintraoperativehyperlactatemiaandmyocardialinjuryafternoncardiacsurgery
AT yangkwangmo associationbetweenintraoperativehyperlactatemiaandmyocardialinjuryafternoncardiacsurgery
AT kimkyunga associationbetweenintraoperativehyperlactatemiaandmyocardialinjuryafternoncardiacsurgery
AT ahnjoonghyun associationbetweenintraoperativehyperlactatemiaandmyocardialinjuryafternoncardiacsurgery
AT leeseunghwa associationbetweenintraoperativehyperlactatemiaandmyocardialinjuryafternoncardiacsurgery