Abstract
Background: Serum lactate is widely used for risk assessment in sepsis, but its interpretation in cirrhosis is complicated by impaired liver function. This study evaluated validity of serum lactate in predicting the outcome in cirrhotic patients with sepsis
Methods: This prospective cohort study included 72adults with sepsis: 36 cirrhotic and 36 noncirrhotic patients. Clinical findings, laboratory parameters, Sequential Organ Failure Assessment (SOFA), quick Sequential Organ Failure Assessment (qSOFA), and serum lactate were assessed at admission and after 48 hours. Patients were followed until discharge or in-hospital death. -
Results: Serum Lactate decreased significantly after 48 hours in the cirrhotic group (P=0.005), but not in the noncirrhotic group. In both groups, nonsurvivors had significantly higher lactate levels at admission and after 48 hours than survivors (all P3.55 mmol/L predicted mortality in cirrhotic patients with an area under the curve of 0.93 and 88.9% accuracy. In noncirrhotic patients, lactate>3.05 mmol/L achieved an area under the curve of 0.93, 84.4% accuracy.
Conclusion: Serum lactate was strongly associated with mortality and organ dysfunction in septic patients with cirrhosis as well as non- cirrhotic patients. It may provide a simple and useful adjunct to established severity scores for early risk stratification, particularly in cirrhotic patients