The Relationship Between Blood Lactate Level and Mortality in Patients Diagnosed with Acute Aortic Dissection in the Emergency Department

Abstract

Objective: Acute aortic dissection is a time-sensitive and difficult-to-diagnose cardiovascular emergency. The aim of this study was to investigate the relation between blood lactate level and mortality in patients diagnosed with acute aortic dissection (AAD) in the emergency department. Material and Methods:The study was conducted by retrospectively examining the electronic files of 32 patients who had been diagnosed with acute aortic dissection by computed tomography angiography in the emergency department and hospitalized between 01 January 2020 and 31 December 2020. Results:Of the patients included in the study, 78.1% were males. Mean age of the patients was 60.9 ± 10.4 years. The most frequent complaints of the patients were chest pain (50%) and back pain (43.8%). When comorbidities were examined, hypertension was the most common (59.4%). Of the patients, 71.9% were treated surgically and 28.1% medically. According to the Stanford classification, 65.6% of the patients had Stanford type A and 34.4% had Stanford type B aortic dissection. Mortality was seen in 50% of the patients. When the relation between laboratory parameters and mortality was examined, mean serum lactate level was 1.6 ± 0.6 mmol/l in surviving patients and 3.5 ± 2.3 mmol/l in mortal patients (p= 0.004). When Reciever Operating Characteristic (ROC) analysis, which determines mortality predictive properties of laboratory parameters, was examined, the Area Under Curve (AUC) value of serum lactate level was determined as 0.875 (95% CI 0.738-1.0, p= 0.004). When the threshold value of serum lactate level determined to predict mortality was 2.1 mmol/l, its sensitivity was determined as 86.7% and specificity as 81.2%. Conclusion:According to the study data, the threshold value of serum lactate level above 2.1 mmol/l in patients with acute aortic dissection may guide the clinician as a new and valuable marker in the evaluation of in-hospital mortality.