SERUM LACTATE AS PROGNOSTIC MARKER IN INDIAN ELDERLY WITH SEPTICEMIA

Abstract

Introduction: Serum Lactate is recognized as a potentially useful prognostic marker to risk stratify patients with severe sepsis and elevated serum lactate is found to be strongly associated with morbidity and mortality in various populations with sepsis. The aim of our study was to determine correlation between serum lactate level in Indian elderly presenting with sepsis with the stage of sepsis and ultimate outcome.

Method: In a single centre prospective, observational study done in geriatric ward of tertiary care centre,200 elderly patients (age>60 yrs) with sepsis were included .The primary outcome was 14 days in hospital mortality. Risk factor variable was venous serum lactate (mg/dl) at presentation.

Result: Mortality at 14 days in elderly patients with sepsis was 20%. Mean serum lactate(mg/dl) in survivor group was 30.16±19.48 while 61.52±31.52 in non survivor group (p value <0.001).The mean serum lactate level(mg/dl) in survivor and non survivors was 24.83±13.71 and 33.58±15.11 in sepsis, 50.56±22.47 and 75.22±11.41 in severe sepsis, 70.75±19.32 and 86.82±11.6 in Multiple organ dysfunction syndrome while 83.50±31.68 and 104.88±14.14 in septic shock group.

Conclusion: We conclude that initial high serum lactate level was associated with increased mortality independent of etiology of sepsis, it also correlate well with severity of sepsis and serum lactate level were high in those with septic shock and diabetic group.