Lactato postoperatorio como predictor de desenlaces clínicos en el paciente con resección de tumores cerebrales

Abstract

Objective: To identify lactate as a predictor of clinical outcomes in care postoperative of patients with resection of brain tumors Design. Observational prospective clinical cohort study. 224 were included patients in postoperative resection of brain tumors admitted to the ICU. The overall in-hospital mortality rate at 28 days was 1.3%. The Lactate levels in the group of patients who died were higher 3.70 (IQR 3.75) vs 1.60 (IQR 1.30), all patients who died at 28 days, they presented hyperlactatemia (p = 0.044). Of all patients, 35.7% had an elevated lactate level, while 64.3% had an elevated lactate low or normal serum. Patients with high-grade tumors, and volumes high tumor levels, presented higher levels of lactate. They were not found differences between the length of hospital stay and the length of stay in the unit of intensive care among patients with hyperlactatemia and low or low lactate normal, as well as there were no differences between these two groups related with readmission to ICU, re-intubation and re-intervention. Conclusion: Patients admitted to the ICU postoperatively for resection of brain tumors have low mortality at 28 days, however 100% of the deceased patients had hyperlactatemia. The clinical outcomes evaluated in ICU they do not correlate with hyperlactatemia, with the exception of rebleeding. We consider that early postoperative lactate measurement could relate to bad outcomes, however a sample is required higher