Impact of lactate dehydrogenase on prognosis of patients undergoing cardiac surgery.
Cardiac surgery
Complications
Lactate dehydrogenase
Medical Information Mart for Intensive Care
Mortality
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
10 09 2022
10 09 2022
Historique:
received:
08
05
2022
accepted:
06
09
2022
entrez:
10
9
2022
pubmed:
11
9
2022
medline:
14
9
2022
Statut:
epublish
Résumé
Lactate dehydrogenase (LDH) has been reported in multiple heart diseases. Herein, we explored the prognostic effects of preoperative LDH on adverse outcomes in cardiac surgery patients. Retrospective data analysis was conducted from two large medical databases: Medical Information Mart for Intensive Care (MIMIC) III and MIMIC IV databases. The primary outcome was in-hospital mortality, whereas the secondary outcomes were 1-year mortality, continuous renal replacement therapy, prolonged ventilation, and prolonged length of intensive care unit and hospital stay. Patients with a primary endpoint had significantly higher levels of LDH (p < 0.001). Multivariate regression analysis presented that elevated LDH was independently correlated with increased risk of primary and secondary endpoints (all p < 0.001). Subgroup analyses showed that high LDH was consistently associated with primary endpoint. Moreover, LDH exhibited the highest area under the curve (0.768) for the prediction of primary endpoint compared to the other indicators, including neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), lactate, and simplified acute physiology score (SAPS) II. The above results were further confirmed in the MIMIC IV dataset. Elevated preoperative LDH may be a robust predictor of poor prognosis in cardiac surgery patients, and its predictive ability is superior to NLR, LMR, PLR, lactate, and SAPS II.
Sections du résumé
BACKGROUND
Lactate dehydrogenase (LDH) has been reported in multiple heart diseases. Herein, we explored the prognostic effects of preoperative LDH on adverse outcomes in cardiac surgery patients.
METHODS
Retrospective data analysis was conducted from two large medical databases: Medical Information Mart for Intensive Care (MIMIC) III and MIMIC IV databases. The primary outcome was in-hospital mortality, whereas the secondary outcomes were 1-year mortality, continuous renal replacement therapy, prolonged ventilation, and prolonged length of intensive care unit and hospital stay.
RESULTS
Patients with a primary endpoint had significantly higher levels of LDH (p < 0.001). Multivariate regression analysis presented that elevated LDH was independently correlated with increased risk of primary and secondary endpoints (all p < 0.001). Subgroup analyses showed that high LDH was consistently associated with primary endpoint. Moreover, LDH exhibited the highest area under the curve (0.768) for the prediction of primary endpoint compared to the other indicators, including neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), lactate, and simplified acute physiology score (SAPS) II. The above results were further confirmed in the MIMIC IV dataset.
CONCLUSIONS
Elevated preoperative LDH may be a robust predictor of poor prognosis in cardiac surgery patients, and its predictive ability is superior to NLR, LMR, PLR, lactate, and SAPS II.
Identifiants
pubmed: 36088306
doi: 10.1186/s12872-022-02848-7
pii: 10.1186/s12872-022-02848-7
pmc: PMC9463775
doi:
Substances chimiques
Lactates
0
L-Lactate Dehydrogenase
EC 1.1.1.27
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
404Informations de copyright
© 2022. The Author(s).
Références
Ann Thorac Surg. 2017 Jan;103(1):32-40
pubmed: 27884410
Angiology. 2020 Nov;71(10):909-915
pubmed: 32720814
J Cardiothorac Vasc Anesth. 2017 Feb;31(1):291-308
pubmed: 27671216
Nephrol Dial Transplant. 2021 Mar 29;36(4):704-712
pubmed: 33367881
Minn Med. 1954 Mar;37(3):181-5
pubmed: 13154150
Ann Thorac Surg. 2020 Jun;109(6):1646-1655
pubmed: 32247780
Eur J Heart Fail. 2002 Oct;4(5):587-91
pubmed: 12413501
Circulation. 2009 Jun 2;119(21):2844-53
pubmed: 19487602
Kardiol Pol. 2017;75(7):666-673
pubmed: 28394006
Clin Chim Acta. 2020 Nov;510:665-670
pubmed: 32828732
BMC Anesthesiol. 2020 Mar 13;20(1):65
pubmed: 32169047
Front Cardiovasc Med. 2021 Feb 22;8:639890
pubmed: 33693038
BMC Nephrol. 2015 May 30;16:76
pubmed: 26025079
Front Pharmacol. 2015 Dec 22;6:296
pubmed: 26733868
Int J Hypertens. 2020 Jan 07;2020:1347165
pubmed: 31969993
Clin Colorectal Cancer. 2007 Mar;6(6):442-6
pubmed: 17531108
Sci Rep. 2021 Jun 21;11(1):12997
pubmed: 34155288
Front Cardiovasc Med. 2021 Sep 17;8:705862
pubmed: 34604350
J Thorac Dis. 2021 Jan;13(1):67-75
pubmed: 33569186
Am Heart J. 1969 Jan;77(1):100-22 contd
pubmed: 4882561
Clin Respir J. 2012 Apr;6(2):81-7
pubmed: 21651741
Int J Cardiol. 2016 Nov 15;223:444-449
pubmed: 27544602
Ann Thorac Surg. 2000 Dec;70(6):2082-6
pubmed: 11156124
Front Cardiovasc Med. 2021 Sep 20;8:706852
pubmed: 34616780
Mol Med Rep. 2019 Jan;19(1):629-637
pubmed: 30483780
Ann Thorac Surg. 2018 Feb;105(2):581-586
pubmed: 29132702
Sci Rep. 2017 Jan 27;7:41530
pubmed: 28128312
Circulation. 2009 May 12;119(18):2444-53
pubmed: 19398670
Medicine (Baltimore). 2016 Feb;95(6):e2776
pubmed: 26871831
Eur J Pharm Sci. 2017 Jan 1;96:37-44
pubmed: 27622920
Toxicol Appl Pharmacol. 2012 Aug 1;262(3):232-7
pubmed: 22569360
J Am Med Assoc. 1957 Sep 7;165(1):35-40
pubmed: 13462739
J R Soc Interface. 2016 Dec;13(125):
pubmed: 28003526
Heart Lung Circ. 2020 Sep;29(9):1318-1327
pubmed: 31862227
Respir Med. 1997 Nov;91(10):616-23
pubmed: 9488895
Sci Data. 2016 May 24;3:160035
pubmed: 27219127
Minn Med. 1954 Mar;37(3):171-85; passim
pubmed: 13154149
J Thorac Cardiovasc Surg. 2013 Aug;146(2):455-60
pubmed: 23507124
Ann Thorac Surg. 2020 Jul;110(1):128-135
pubmed: 31785288