Key result
Early postoperative lactate predicts ~9-fold higher odds of complications and mortality after liver resection.
Why the study?
The study was conducted to analyze perioperative lactate levels and evaluate their predictive value for postoperative mortality and morbidity after liver resection.
Do perioperative serum lactate levels predict postoperative morbidity and mortality in patients undergoing liver resection?
Cohort (n=152)
Do perioperative serum lactate levels predict postoperative morbidity and mortality in patients undergoing liver resection?
Effect estimate: OR 9.28 (95% CI 2.88-29.9)
p-value: p=< 0.001
Early postoperative serum lactate levels are strong predictors of morbidity and mortality following liver resection.
May support lactate monitoring for risk stratification after liver resection; leaves open whether interventions improve outcomes.
Background: The aim of our study was to analyze perioperative lactate levels and their predictive value for postoperative mortality and morbidity after liver resection. Methods: The clinicopathological characteristics and outcomes of 152 patients who underwent liver resection for benign and malign diagnoses were analyzed retrospectively. Lactate concentrations at three different time points, (1) before liver resection (LAC-PRE), (2) after liver resection on day 0 (LAC-POST), and (3) on day one after the operation (LAC-POD1) were assessed regarding the prognostic value in predicting postoperative complications and mortality according to the Clavien–Dindo (CD) classification. Results: The rates of postoperative complications (CD ≥ IIIb) and mortality rates were 19.7% (N = 30) and 4.6% (N = 7), respectively. The LAC-PRE levels showed no correlation with the postoperative outcome. The ROC curve analysis showed that LCT-POST and LCT-POD1 values were moderately strong in predicting postoperative morbidity (0.681 and 0.768, respectively) and had strong predictive accuracies regarding postoperative mortality (0.800 and 0.838, respectively). The multivariate analysis revealed LAC-POST as a significant predictor of postoperative complications (CD ≥ IIIb: OR 9.28; 95% CI: 2.88–29.9; p < 0.001) and mortality (OR 11.69; 95% CI: 1.76–77.7; p = 0.011). Conclusion: Early postoperative lactate levels are a useful and easily practicable predictor of postoperative morbidity and mortality in patients after liver resection.
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Recknagel et al. (2023) conducted a cohort in Liver resection for benign and malign diagnoses (n=152). Perioperative serum lactate levels was evaluated on Postoperative complications (CD ≥ IIIb) (OR 9.28, 95% CI 2.88-29.9, p=< 0.001). Early postoperative lactate levels (LAC-POST) significantly predicted postoperative complications (OR 9.28; 95% CI 2.88-29.9; p<0.001) and mortality after liver resection.
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