Prognostic significance of lactate clearance in severe acute pancreatitis

Authors : Betül Çiğdem Yortanlı, Korhan Kollu, Burcu Kuş, Ekrem Taha Sert, Mehmet Yortanlı

Pages : 450-459

Doi:10.17826/cumj.1639534

View : 100 | Download : 201

Publication Date : 2025-06-30

Article Type : Research Paper

Abstract :Purpose: This study aimed to evaluate the prognostic value of lactate clearance in predicting severe acute pancreatitis (SAP) in patients with acute pancreatitis (AP). Identifying early biomarkers for SAP can help in risk stratification and guide clinical management. Materials and Methods: This retrospective, single-center observational study included 183 patients diagnosed with AP between January 2022 and January 2023. Patients were classified as SAP or non-SAP based on the 2012 Atlanta Classification. Demographic data, laboratory parameters, and clinical outcomes were analyzed. Lactate clearance was calculated as [(initial lactate – 24-hour lactate)/initial lactate] × 100.. Results: Among 183 patients, 105 (57.4%) had SAP. SAP patients had significantly longer hospital stays, higher intensive care unit admissions, and increased mortality rates). SAP patients had significantly higher initial and 24-hour lactate levels but lower lactate clearance. Lower lactate clearance was an independent predictor of SAP (OR: 3.051, 95% CI: 2.030–5.072, p<0.001). ROC analysis revealed that lactate clearance had an AUC of 0.835 (95% CI: 0.776–0.894), with 81.9% sensitivity and 76.9% specificity at a cutoff value of 40.9%. Conclusion: Low lactate clearance is strongly associated with SAP development, longer hospitalization, ICU need, and increased mortality. Lactate clearance may serve as a valuable early prognostic marker. Future studies should explore integrating lactate clearance with markers such as SII, SII/albumin ratio, and RDW to enhance risk stratification and clinical decision-making in AP.
Keywords : Akut pankreatit, Laktat klirensi, Prognostik biyobelirteç

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