L-lactate in acute mesenteric ischemia: a reliable biomarker for diagnosis and prognosis?
Emergency Care Journal, cilt.21, sa.3, 2025 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 21 Sayı: 3
- Basım Tarihi: 2025
- Doi Numarası: 10.4081/ecj.2025.14023
- Dergi Adı: Emergency Care Journal
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
- Anahtar Kelimeler: acute mesenteric ischemia, l-lactate, mortality, prognosis, biomarker, resection length, ROC analysis
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Acute mesenteric ischemia is a life-threatening condition with high mortality, often caused by arterial or venous hypoperfusion of the intestines. Early diagnosis remains challenging due to nonspe-cific clinical findings and the unreliability of laboratory biomark-ers. Serum L-lactate, a marker of tissue hypoperfusion, has been investigated as a potential prognostic and diagnostic indicator in acute mesenteric ischemia. This retrospective study analyzed 75 patients who underwent emergency surgery for acute mesenteric ischemia between 2010 and 2015. Demographic data, comorbidi-ties, preoperative serum L-lactate levels, operative details, intestinal resection length, and survival outcomes were collected and statistically evaluated. ROC analysis was used to assess the diagnostic power of L-lactate in predicting the extent of bowel resection and to define a cut-off value. The overall mortality rate was 62.7%. Mortality was significantly associated with age ≥65 (p=0.011) and the presence of diabetes mellitus (p=0.041). Preoperative serum L-lactate levels were significantly higher in non-survivors than in survivors (median: 4.88 mmol/L vs. 3.00 mmol/L; p=0.011). However, no significant correlation was found between L-lactate levels and bowel resection length (p=0.316). ROC analysis failed to identify a statistically significant cut-off value for L-lactate in predicting resection extent (AUC=0.580; p=0.316). Preoperative serum L-lactate levels are significantly associated with mortality in patients with acute mesenteric ischemia and may serve as a prognostic biomarker. However, they do not reliably predict the extent of intestinal resection. Larger, prospective studies are required to define clinically meaningful diagnostic thresholds for L-lactate in acute mesenteric ischemia.