BACKGROUND:Early predictors of morbidity after cardiac operations are lacking. Elevated lactate concentrations in the immediate postoperative period reflect unmet metabolic demand and may be associated with outcome. This study examined the association between early plasma lactate concentrations and outcome after cardiac operations. METHODS:As a retrospective cohort investigation, patient information was obtained from the Cardiovascular Information and the Anesthesiology Institute's patient registries. Inclusion criteria were all adult cardiac surgical patients undergoing isolated coronary artery bypass grafting or valve procedures, or coronary artery bypass grafting with a valve procedure, from January 1, 2008, to August 7, 2008 (arterial lactate values were added to the patient registry beginning January 1, 2008). RESULTS:Lactate concentrations during the initial 12 postoperative hours of a patient's stay in the cardiovascular intensive care unit were averaged (mean lactate concentration), and linear regression concentrations over time were used to predict when the lactate concentration would reach 1.5 mmol/L in individual patients (predicted lactate clearance time). We also considered the product of the mean and clearance (product value). Predicted lactate clearance time, mean lactate concentration, and product value were associated with any type of reoperation, death, and a set of composite outcomes (p < 0.001 for each). The accuracy of these indices was moderate to good, with the highest C statistic (for product value) being 0.82. CONCLUSIONS:Predicted lactate clearance time, mean lactate concentration, and product value are each associated with death, any type of reoperation, and a set of composite outcomes in patients undergoing coronary artery bypass grafting or valve operations, or both. Product value provided the best early prognostic guidance in individual patients.

译文

背景:缺乏心脏手术后发病的早期预测因子。术后即刻升高的乳酸浓度反映出未满足的代谢需求,可能与结果有关。这项研究检查了早期血浆乳酸水平与心脏手术后预后之间的关系。
方法:作为一项回顾性队列研究,从心血管信息和麻醉学研究所的患者登记处获得患者信息。纳入标准为从2008年1月1日至2008年8月7日,所有接受隔离冠状动脉搭桥术或瓣膜手术或采用瓣膜冠状动脉搭桥术的成年心脏外科手术患者(从开始时开始将动脉血乳酸值添加到患者登记表中) 2008年1月1日)。
结果:将患者在心血管重症监护病房住院的最初12个术后小时的乳酸浓度进行平均(平均乳酸浓度),并使用随时间的线性回归浓度来预测个体中乳酸浓度何时达到1.5 mmol / L。患者(预计乳酸清除时间)。我们还考虑了均值与清除率的乘积(乘积值)。预测的乳酸清除时间,平均乳酸浓度和产品价值与任何类型的再次手术,死亡和一组综合结果相关(每种p <0.001)。这些指数的准确性为中等到良好,最高C统计量(对于产品值)为0.82。
结论:预测的乳酸清除时间,平均乳酸浓度和产品价值均与进行冠状动脉搭桥术或瓣膜手术或两者的患者的死亡,任何类型的再次手术以及一系列综合结果有关。产品价值为个别患者提供了最好的早期预后指导。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录