Mathijsen, Anouk (2024) Gecombineerd lactaat en glucose: Een vroege voorspeller van leverfalen en mortaliteit bij patiënten op de spoedeisende hulp. thesis, Medicine.
Full text available on request.Abstract
Introduction Glucose is synthesized in the liver from lactate (Cori cycle). Elevated lactate without an increase in glucose might therefore be indicative of emerging liver failure. The prognostic value of combined lactate and glucose levels for the prediction of liver failure and/or mortality in the Emergency Department (ED) has not been studied. Methods A retrospective cohort study was conducted in the ED of the University Medical Center Groningen. In a cohort of 6475 adult patients who underwent blood gas analysis during their ED visit between May 2023 and December 2023, we analyzed lactate and glucose levels and related these to the occurrence of liver failure (defined as a bilirubin ≥33 μmol/L within 7 days after presentation at the ED, primary endpoint) and mortality within 3 months of presentation (secondary endpoint). The incidence of these endpoints was compared for tertiles created based on lactate and glucose levels. Logistic regression analysis was performed to investigate the relation between lactate and glucose levels and outcome. Results A total of 3301 patients (59% male) were included, of whom 6% developed liver failure (mortality of 23%). Higher lactate levels were associated with liver failure and mortality (both p<0.001), whilst glucose was negatively associated with liver failure (p=0.034), but not with mortality. Patients with the highest tertile lactate (>1.9 mmol/l) and the lowest tertile glucose (<5.9 mmol/l) had an higher incidence of liver failure (OR 2.09 [95% CI 1.33-3.28], p=0.003) and mortality (OR 1.56 [95% CI 1.10-2.21], p=0.015). Conclusion An elevated lactate combined with a low/normal glucose appears to be associated with an increased risk of liver failure and mortality.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | ter Avest, E. and Deodatus, A. |
| Faculty: | Medical Sciences |
| Date Deposited: | 23 Oct 2024 11:40 |
| Last Modified: | 23 Oct 2024 11:40 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3775 |
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