Serum Lactate Dehydrogenase Levels: The Grim Reaper Sign in Acute Pancreatitis?

Division

Far West

Hospital

Southern Hills Hospital & Medical Center

Document Type

Manuscript

Publication Date

1-6-2025

Keywords

Critical, Gender, Hospital stay, Lactate dehydrogenase, Mortality, Obesity, Pancreatitis, Severity

Disciplines

Digestive System Diseases | Gastroenterology | Internal Medicine | Medicine and Health Sciences

Abstract

BACKGROUND AND AIMS: Acute pancreatitis (AP) frequently presents in emergency departments and poses challenges in predicting severity and mortality. Established scoring systems like Ranson criteria, Acute Physiology And Chronic Health Evaluation II (APACHE) II, and Bedside Index of Severity in Acute Pancreatitis (BISAP) have varying effectiveness. Lactate dehydrogenase (LDH), an enzyme released during tissue damage, shows promise as a marker for organ injury in AP. This study aimed to evaluate LDH's potential to predict mortality risk and hospital stay duration in AP patients.

METHODS: A retrospective cohort study analyzed AP cases at HCA Healthcare facilities from January 2011 to January 2021. Among 514 patients with LDH data at admission, groups were categorized based on LDH levels. Outcomes included hospital and ICU stay lengths, mortality rates, and factors such as age, gender, race, BMI, and medical history.

RESULTS: Patients were stratified into three groups: Group 1 (/L), Group 2 (300-600 IU/L), and Group 3 (>600 IU/L) based onLDHlevels. Patients withLDH>600 IU/L experienced an average hospital stay extension of 4.5 days,were 3.2 times more likely to require ICU admission, and faced a 12.1 times higher mortality risk compared to those with LDH/L.

CONCLUSION: This study highlights LDH as a potentially valuable predictor of hospital stay duration, ICU requirements, and mortality rates in AP patients. Its cost-effectiveness and accessibility suggest LDH testing could aid clinical decision-making in AP management. Future prospective studies should further explore LDH's role in optimizing AP patient care.

Publisher or Conference

Journal of Community Hospital Internal Medicine Perspectives

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