Evaluation of Serum Lactate, pH and Procalcitonin Level as a Prognostic Indicator for Mortality among Secondary Peritonitis Patients in a Tertiary Care Hospital

Background: The present study was carried out to evaluate the serum lactate, pH and procalcitonin level as a prognostic indicator for mortality among secondary peritonitis patients. Material and Methods: This cross sectional study was conducted by Department of Surgery, IGMC, Shimla over a period of twelve months from January 2021 – December 2021 among patients with a diagnosis of secondary peritonitis after fulfilling the inclusion and exclusion criteria. Relevant information was collected and further analysed by using IBM SPSS Statistics. Results: A total of 250 individuals with a diagnosis of perforation peritonitis were assessed. Of the total, 32 (12.80%) passed away while 218 (87.20%) were discharged. Mean Pre (AL1), Postoperative (AL24) lactate level and Absolute lactate clearance (AL1 - AL24) was 2.48±1.42 and 1.74±1.52 and 0.74 mmol/L respectively. There was significant difference in the AL1 and AL24. Mean AL1 in expired patients was 3.78±2.24 mmol/L while among discharged patients it was 2.29 ±1.15 mmol/L and its increased level was significantly associated with mortality. The mean AL24 in expired patients was 3.67±3.18 mmol/L while among discharged patients it was 1.45 ±0.76 mmol/L and its increased level was significantly associated with mortality. The mean AL1 - AL24 in expired patients was 0.11±2.79 mmol/L while among discharged patients it was 0.84 ±1.1- mmol/L and its decreased level was significantly associated with mortality. Mean Pre (pH1), Postoperative (pH24) pH level and Procalcitonin was 7.33±0.10 and 7.35±0.11 and 0.88±0.80 ng/ml respectively. Mean pH1 in expired patients was 7.16±0.09 while among discharged patients it was 7.36 ±0.08 and its decreased level was significantly associated with mortality. The mean pH24 in expired patients was 7.17±0.13 mmol/L while among discharged patients it was 7.38 ±0.07 and its decreased level was significantly associated with mortality. The mean Procalcitonin level in expired patients was 2.58 ±1.26 ng/ml while among discharged patients it was 0.63 ±0.18 ng/ml and its increased level was significantly associated with mortality. Conclusion: The study concluded that increased Pre (AL1), Postoperative (AL24) lactate and Procalcitonin level while decreased Absolute lactate clearance (AL1 - AL24) , Pre (pH1) and Postoperative (pH24) pH level was significantly associated with mortality.