ROLE OF SERIAL SERUM LACTATE LEVELS AS PROGNOSTIC PREDICTOR IN EMERGENCY LAPAROTOMY PATIENTS

Abstract

Objective: The purpose of the research is to find out the role of serial serum lactate levels as prognostic predictor in emergency laparotomy patients

Study Design: Prospective Observational Comparative Study

Study Duration: 06 months from August 2024-Janurary 2025

Study Place: Department of General Surgery, CMH Lahore

Methods: A prospective observational research was carried out in the general surgery department following the ethical approval. Adult patients who were subjected to emergency laparotomy were sampled randomly. Lactate serum levels were taken at admission, 6 hours after surgery, 24 and 48 hours. Trends were calculated through the calculation of lactate clearance. In-hospital mortality was used as a primary outcome and postoperative complications, Statistical data analysis was done in SPSS 26 and p-value less than <.05 was considered significant.

Results: A total of 141 patients undergoing emergency laparotomy were analyzed, with a mean age of 52.6 ± 15.4 years and a male-to-female ratio of 1.6:1. Most patients were classified as ASA III–IV (68.1%). Overall survival was 78.0%, while mortality was 22.0%. Survivors showed a declining trend in serum lactate levels, whereas non-survivors had persistently elevated levels (p < 0.001). Higher admission lactate levels and failure of lactate clearance at 24 hours were significantly associated with increased mortality, prolonged ICU stay, and organ dysfunction.

Conclusion: Serial serum lactate monitoring is useful prognostic data in emergency laparotomy patients. High admission lactate and delayed postoperative lactate clearance is associated with high morbidity.