Objective The high blood lactic acid level in critically ill patients is an important indicator of the severity of the disease. The purpose of this study was to explore the relationship between the blood lactic acid level and SOFA score, and provide a reference for the assessment of the severity of the illness and prognosis of patients with intra-abdominal infection.
Methods Total 63 patients with intra-abdominal infection admitted to the first affiliated hospital of Wen-Zhou Medical University in February 2015 to October 2017 were enrolled into this study. The general information, acute physiology and chronic health evaluation (APACHE) Ⅱ score, SOFA score were recorded. The initial blood lactate level was recorded, the clinical data were compared between the hyperlactatemia group (Lac > 2 mmol/L) and the normal group (Lac≤2 mmol/L). By using the area under the ROC curve to calculate the cut-off point of the initial lactic acid， APACHE Ⅱ, and Sequential Organ Failure Assessment (SOFA) score. Pearson analysis was conducted to analyze the correlation between lactic acid, APACHE Ⅱ score and SOFA score. logistic regression analysis was performed to analyze the risk factors affecting the prognosis.
Results Among the 63 patients, the incidence of hyperlactic acidemia rate was 77.8%. The APACHE Ⅱ score and SOFA score in the hyper-lactic acid group were significantly higher than that in the normal group [15.00(12.00, 20.25) vs. 10.00(10.00, 12.75), 7.00(6.00,9.00) vs. 5.00(3.00,6.00), all
P<0.05)]. The AUC among lactic acid, APACHE Ⅱ score and SOFA score were 0.692, 0.787, 0.726 respectively (
P=0.022, 0.002, 0.041). The optimal cut-off point of them were 5.0 mmol/L, 13.5 and 6.5, respectively. Pearson correlation analysis showed that blood lactate was positively correlated with APACHE Ⅱ and SOFA scores (
r=0.594,
P<0.001;
r=0.562,
P<0.001). Logistic regression analysis showed that the level of lactic acid and APACHE Ⅱ score were independent risk factors for the prognosis of patients with intra-abdominal infection disease (
P=0.003,0.015).
Conclusion High blood lactic acid on admission in patients with intra-abdominal infection is an independent risk factor for assessing prognosis. Besides, it is an important quantitative indicator in assessing the severity of the disease, if combined with the APACHE Ⅱ and SOFA score.
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