Lactate Level as a Prediction Factor of Reperforation after Repairing Gastric Perforation

Abstract

Reperforation after gastric perforation repair is a complication which increases the rate of morbidity and mortality in gastric perforation. The lack of ability of the tissue to use oxygen in septic condition causes anaerobic cellular metabolism and furthermore it will cause failure in closing the perforation. The production of anaerobic metabolism is lactic acid which can be measured from the blood. The aim of this study is to determine the cut-off point of blood lactate level as a predictor of reperforation after repairing gastric perforation. Forty-six patients diagnosed as gastric perforation, who were repaired in Dr Soetomo Hospital from October 2014 to October 2015 were recruited as samples. Serum lactate was taken one hour before repairing the perforation. After being repaired, the patients were observed until the 14th day to evaluate whether any reperforation would occur or not . The design of this research was cross-sectional, analytic observational. The data was analyzed using independent t-test and ROC for obtaining the cut-off point as a predictor of the reperforation after the gastric perforation was repaired. There was a significant difference in the mean of lactate level in the group with reperforation compared with that of the non-reperforation group, that is as big as 3.74±0.59 mmol/L and 2.60±0.76 mmol/L. Using ROC curve analysis, there was the cut-off point of lactate level for reperforation 3.35 mmol/L, with sensitivity 92.9%, specificity 84.4%, positive predictive value 72% and negative predictive Value 96.4%, accuracy 87.0% and in the AUC value 0.902.

effect of a free peritoneal patch on bursting pressure in primary colonic anastomosis with intraperitoneal infection conditions

“…Fecal induced peritonitis for animal research as identical as human model data which caused sepsis based on SOFA Score evaluation, inflammatory response duration from induction until host bacteremia condition is consistent although sepsis duration is not (Park I, et al, 2019). In septic condition there is a defect in cellular oxygen utilization, anaerobic metabolism occur and blood lactate level will increase as a result (Budipramana VS, 2021). An initial supportive therapy and parenteral broadspectrum antibiotics were prominently important to undertake while waiting for further diagnostics and therapies arrangements were made (Pranata AK, 2021).…”

Comparative study of SOFA, WSESSSS, and CPIRO scoring systems as mortality predictors in a patient with complicated intra-abdominal infection

“…[5][6][7][8][9] Early systemic infection and systemic inflammation could be identified by various laboratory parameters, such as leucocyte, lactate level, and C-reactive protein. 10,11 Currently, there are various sepsis severity score systems available, and they are useful for predicting mortality in cIAI patients. The SOFA (Sequential Organ Failure Assessment) score could be used generally in cases of sepsis, while the CPIRO (Calgary Predisposition Infection Response and Organ Dysfunction) scores and the WSESSSS (World Society of Emergency Surgery Sepsis Severity Score) were thought to be accurate in a large population with cIAI.…”

The Most Dominant Predictability Factor of Boey Score on The Level of Mortality in Perforation Gaster Boey Score 1 and Boey Scores 2 Patients in RSUD Dr Soetomo Surabaya

“…This score is widely used because it is easy in daily practice because it only assesses 3 variables components; namely the onset of perforation, shock at first admission, and comorbid disease; which is easy to do and has pretty good accuracy. 1,8,9 A preliminary study by Boey et al showed that patients with risk factors 0, 1, 2 and 3 who underwent laparotomy had a mortality rate of 0%, 14.1%, 58% and 100%. 2 The results of Boey's research (1982) are almost the same as the results of research conducted at the Dr. Soetomo Hospital in Surabaya, it was found that from a total of 33 cases of gastric perforation performed by laparotomy in 2018, 27.3% of cases of gastric perforation were obtained with a Boey score 2 assessment with a mortality rate of 11.1.…”