【原】【罂粟摘要】肝移植期间术中乳酸浓度对早期死亡率临界值的预测：回顾性分析3338例病例

---

肝移植期间术中乳酸浓度对早期死亡率临界值的预测：回顾性分析3338例病例 

贵州医科大学麻醉与心脏电生理课题组  

翻译：安丽 编辑：陈锐 审校：曹莹

HOLIDAY

目的

我们旨在探讨肝移植术（LT）中乳酸（LA）水平的分布，并确定预测LT后30天和90天死亡率的最佳临界值。

HOLIDAY

方法

收集了2008年至2019年期间3338例LT患者的术中LA数据，并回顾性分析了30天和90天内的全因死亡率。关于在肝移植前、无肝期和新肝期测量的三种LA水平中，选择LA峰值水平来探索其分布并预测LT后早期死亡率。为了确定LA的最佳临界值，我们使用了分类和回归树算法，并最大限度地选择具有最小P值的秩统计量。

HOLIDAY

结果

术中LA水平中位数为4.4 mmol/L（范围：0.5-34.7mmol/L，四分位范围：3.0-6.2 mmol/L）。在3338名患者中，1884名（56.4%）的LA水平>4.0 mmol/L，188名（5.6%）的LA水平>10 mmol/L。LA水平>16.7 mmol/L和13.5–16.7 mmol/L的患者的30天死亡率分别58.3%和21.2%。对于90天死亡率的预测，术中LA值为8.4 mmol/L是最佳临界值。

HOLIDAY

结论

大约6%的LT接受者在LT期间术中表现出>10 mmol/L的高乳酸血症，而LA>8.4 mmol/L的患者与LT后早期死亡率显著升高相关。

HOLIDAY

原始文献来源

Kyoung-Sun Kim , Sang-Ho Lee , Bo-Hyun Sang , and Gyu-Sam Hwang.Intraoperative lactic acid concentration during liver transplantation and cutoff values to predict early mortality: a retrospective analysis of 3,338 cases.Anesth Pain Med (Seoul) 2021 Dec 31.doi.org/10.17085/apm.21056.

---

Intraoperative lactic acid concentration during liver transplantation and cutoff values to predict early mortality:a retrospective analysis of 3,338 cases

Background: We aimed to explore the distribution of intraoperative lactic acid (LA) level during liver transplantation (LT) and determine the optimal cutoff values to predict post-LT 30-day and 90-day mortality

Methods: Intraoperative LA data from 3,338 patients were collected between 2008 to 2019 and all-cause mortalities within 30 and 90 days were retrospectively reviewed. Of the three LA levels measured during preanhepatic, anhepatic, and neohepatic phase of LT, the peak LA level was selected to explore the distribution and predict early post-LT mortality. To determine the best cutoff values of LA, we used a classification and regression tree algorithm and maximally selected rank statistics with the smallest P value.

Results: The median intraoperative LA level was 4.4 mmol/L (range: 0.5–34.7, interquartile range: 3.0–6.2 mmol/L). Of the 3,338 patients, 1,884 (56.4%) had LA levels > 4.0 mmol/L and 188 (5.6%) had LA levels > 10 mmol/L. Patients with LA levels > 16.7 mmol/L and 13.5–16.7 mmol/L showed significantly higher 30-day mortality rates of 58.3% and 21.2%, respectively. For the prediction of the 90-day mortality, 8.4 mmol/L of intraoperative LA was the best cutoff value.

Conclusions: Approximately 6% of the LT recipients showed intraoperative hyperlactatemia of > 10 mmol/L during LT, and those with LA > 8.4 mmol/L were associated with significantly higher early post-LT mortality.

别忘了点赞哦~😊