Early lactate clearance in predicting prognosis of critically ill patients with acute upper gastrointestinal bleeding

Objective To investigate the clinical value of early lactate clearance in predicting prognosis of patients with acute upper gastrointestinal bleeding (UIGB). Methods One hundred and sixty-eight patients with UIGB admitted to the emergency department of Chinese PLA General Hospital from January to May in 2016 were enrolled in this study. The patients' demographic data, including past history, drug history, vital signs on admission and laboratory test and early lactate clearance were analyzed. All patients were followed up for 3 months, and the relationships between early lactate clearance with mortality and re-bleeding were assessed using univariate and multivariate analysis. Results Mortality and re-bleeding rates of 168 patients were 23.2% and 34.5%, respectively.Univariate analysis found that early lactate clearance of patients within 3 months death was significantly lower than that of survival patients (13% vs 28%, P< 0.01). During follow-up period, early lactate clearance of re-bleeding patients was significantly lower than that of non-bleeding patients (12% vs 28%, P< 0.01). Early lactate clearance was explored to be an independent risk factor of patients' survival (OR: 0.15; 95% CI: 0.04-0.51; P< 0.01) and re-bleeding (OR: 0.26; 95% CI: 0.08-1.04; P< 0.01) by multivariate logistic regression. Conclusion Lactate clearance may be associated with prognosis in critically ill patients with UGIB, and it can be used as a predicting indicator for mortality and recurrent bleeding.