Centenarian lactate

Document Type

Conference Proceeding

Publication Date

1-1-2022

Publication Title

Crit Care Med

Abstract

INTRODUCTION: Based on the WHO data, from 2000 to 2019, global life expectancy has increased by 6 years to 73.4 years. In developed countries, the estimated life expectancy is 79 years for men and 82 years for women. With a higher possibility of people reaching age 100 or older, little is known about the usefulness of lactate (LA) for risk stratification in the population of centenarians. METHODS: We reviewed a deidentified data set from an urban teaching hospital from 01/2000 to 03/2021. LA data for patients age 100 or older at the time of the LA evaluation was grouped into LA levels of < 4 mmol/L and ≥ 4 mmol/L, along with evaluation of lactate clearance (LAC) and mortality. RESULTS: We identified 388 encounters for patients older than 100 years ranging from 100 to 114 years old (average 102.02±2.04), with increasing trends of LA test utilization from 2000 to 2021. Female patients account for 322, 83% of LA evaluations. Average 1st LA was 2.33±2.0 mmol/L for all patients, ranging from 0.4 to 17.3 mmol/L. Higher 1st LA values were observed in patients with multiple LA draws (2.91±1.75 mmol/L) compared to patient with single LAs (1.98±1.84 mmol/L). Overall, in-hospital mortality was 100, 25.8% with higher mortality in patients with multiple LA draws (45, 37.2%). LA ≥ 4 was present in 39, 10.1% of patients. Inhospital mortality for these patients was 22, 56.7%. LAC was available for 114 patients with average LAC of 26.7±25.8%. LAC < 20% was present in 43 of those patients with an observed in-hospital mortality of 15, 34.9% compared to a mortality of 16, 22.5% in patients with LAC ≥20%. CONCLUSION: In centenarians, more female patients are evaluated with LA. LA ≥4 mmol/L indicates high risk of mortality in this age group, similar to the general population. Centenarians that achieve LAC >20% have better chances of surviving to hospital discharge, indicating possible considerations for targeted resuscitation. The results need to be viewed with caution as various confounders are present.

PubMed ID

Not assigned

Volume

50

Issue

1530-0293

First Page

227

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