Preoperative arterial lactate and outcome after surgery for type A aortic dissection: The ERTAAD multicenter study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F23%3A43926109" target="_blank" >RIV/00064173:_____/23:43926109 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11120/23:43926109

Result on the web

<a href="https://doi.org/10.1016/j.heliyon.2023.e20702" target="_blank" >https://doi.org/10.1016/j.heliyon.2023.e20702</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.heliyon.2023.e20702" target="_blank" >10.1016/j.heliyon.2023.e20702</a>

Result language

angličtina

Original language name

Preoperative arterial lactate and outcome after surgery for type A aortic dissection: The ERTAAD multicenter study

Original language description

BACKGROUND: Acute type A aortic dissection (TAAD) is associated with significant mortality and morbidity. In this study we evaluated the prognostic significance of preoperative arterial lactate concentration on the outcome after surgery for TAAD. METHODS: The ERTAAD registry included consecutive patients who underwent surgery for acute type A aortic dissection (TAAD) at 18 European centers of cardiac surgery. RESULTS: Data on arterial lactate concentration immediately before surgery were available in 2798 (71.7 %) patients. Preoperative concentration of arterial lactate was an independent predictor of in-hospital mortality (mean, 3.5 +- 3.2 vs 2.1 +- 1.8 mmol/L, adjusted OR 1.181, 95%CI 1.129-1.235). The best cutoff value preoperative arterial lactate concentration was 1.8 mmol/L (in-hospital mortality, 12.0 %, vs. 26.6 %, p &lt; 0.0001). The rates of in-hospital mortality increased along increasing quintiles of arterial lactate and it was 12.1 % in the lowest quintile and 33.6 % in the highest quintile (p &lt; 0.0001). The difference between multivariable models with and without preoperative arterial lactate was statistically significant (p = 0.0002). The NRI was 0.296 (95%CI 0.200-0.391) (p &lt; 0.0001) with -17 % of events correctly reclassified (p = 0.0002) and 46 % of non-events correctly reclassified (p &lt; 0.0001). The IDI was 0.025 (95%CI 0.016-0.034) (p &lt; 0.0001). Six studies from a systematic review plus the present one provided data for a pooled analysis which showed that the mean difference of preoperative arterial lactate between 30-day/in-hospital deaths and survivors was 1.85 mmol/L (95%CI 1.22-2.47, p &lt; 0.0001, I(2) 64 %). CONCLUSIONS: Hyperlactatemia significantly increased the risk of mortality after surgery for acute TAAD and should be considered in the clinical assessment of these critically ill patients.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2023

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Heliyon

ISSN

2405-8440

e-ISSN

2405-8440

Volume of the periodical

9

Issue of the periodical within the volume

10

Country of publishing house

GB - UNITED KINGDOM

Number of pages

10

Pages from-to

"e20702"

UT code for WoS article

001092450400001

EID of the result in the Scopus database

2-s2.0-85173148482