Objective: In our study, it was aimed to determine the diagnostic and prognostic value of lactate level in patients with gastrointestinal bleeding.
Methods: This study was performed by retrospective screening of the information of patients who applied to the tertiary education and research hospital with acute gastrointestinal bleeding. Data such as lactate level, age, gender, application complaint, known diseases, medications used, physical examination symptoms and findings, laboratory results, endoscopy and/or colonoscopy reports, treatment were collected and their effects on prognosis and mortality were evaluated.
Results: The median age of 506 patients included in the study was 67 (IQR: 53-80) and 61.3% of the patients were male. 87.5% of the patients were upper and 12.5% lower gastrointestinal bleeding. No relation was found between bleeding region and lactate level (p=0.759). The lactate level of patients who needed erythrocyte suspension, who underwent intensive care and died, was found to be high (p<0.001, p=0.009, p<0.001, respectively). When the test performance of lactate in predicting mortality was evaluated, the AUC value was calculated as 0.714 cm2 according to the ROC curve (p<0.001). When the cut-off value was taken as 4 mmol/L, the sensitivity of lactate in predicting mortality was 29%, specificity was 91%, positive predictive value was 31%, negative predictive value was 90%, positive likelihood ratio was 3.22 and negative likelihood ratio was 0.78.
Conclusion: Lactate level is a test that can be used as a follow-up parameter in both upper and lower gastrointestinal system hemorrhage cases to confirm diagnosis and predict prognosis. In the cases with high lactate value, more hospitalization time, more erythrocyte suspension supplement requirement, increased risk of hospitalization and death were determined.