The Association of Early Combined Lactate and Glucose Levels and Hospital Mortality in Critically ill Patients

Abstract

ince early 1960s, blood lactate concentrations have been used widely as a marker of altered tissue perfusion in critically ill patients. Hyperlactatemia is a hallmark characteristic of shock states and the degree of increase in lactate concentrations is directly related to the severity of the shock state and to mortality rates. On the other hand, both hyperglycemia and hypoglycemia in the intensive care unit (ICU) patient have long been associated with increased morbidity and mortality. The worsened outcome from hyperglycemia occurs not only in patients with diabetes, but also in non-diabetics when enhanced glycogenolysis and gluconeogenesis combined with impaired glucose consumption and impaired glycogen production lead to stress-induced hyperglycemia. Recently, a growing body of evidence has suggested that abnormal combined lactate and glucose levels may provide an early indication of organ dysfunction in ICU patients. Therefore, we conducted the present prospective study in order to investigate whether the risks of morbidities and mortality are higher in ICU patients with hyperlactatemia and higher/lower glycemic level. In the present study, we included 100 cases that had an ICU stay of at least 12 hours. The mean age of the included patients was 46.2 ±15.4 year