The relationship between serum lactate dehydrogenase level and mortality in critically ill patients
Abstract
Background: To assess the association between serum lactate dehydrogenase (LDH) levels and mortality in intensive care unit patients. Materials & methods: A total of 1981 patients in the eICU Collaborative Research Database were divided into four groups according to quartiles of LDH levels. Logistic regressions were performed. Results: Elevated LDH levels were significantly associated with higher mortality (intensive care unit mortality: Q2 vs Q1: 1.046 [0.622–1.758]; Q3 vs Q1: 1.667 [1.029–2.699]; and Q4 vs Q1: 1.760 [1.092–2.839]). Similar results persisted in patients with different acute physiology and chronic health evaluation IV scores, and with or without sepsis. Conclusion: The serum LDH level may aid in the early identification of mortality risk in critically ill patients.
References
- 1. Cardiac intensive care unit management of patients after cardiac arrest: now the real work begins. Canadian J. Cardiol. 34(2), 156–167 (2018).
- 2. Update in management of severe hypoxemic respiratory failure. Chest 152(4), 867–879 (2017).
- 3. . ICU management of trauma patients. Crit. Care Med. 46(12), 1991–1997 (2018).
- 4. . A glycolytic pathway to apoptosis of hypoxic cardiac myocytes. Molecular pathways of increased acid production. Adv. Exp. Med. Biol. 475, 161–175 (2000).
- 5. . Lactic dehydrogenases: functions of the two types pates of synthesis of the two major forms can be correlated with metabolic differentiation. Science 143(3609), 929–933 (1964).
- 6. . Lactate dehydrogenase. Biochemistry and function of lactate dehydrogenase. Cell Biochem. Function 2(3), 131–134 (1984).
- 7. . Comparative enzymology-new insights from studies of an ‘old’ enzyme, lactate dehydrogenase. Comp. Biochem. Physiol. B Biochem. Mol. Biol. 199, 13–20 (2016).
- 8. Expression of lactate dehydrogenase is induced during hypoxia via HIF-1 in the mud crab Scylla paramamosain. Comp. Biochem. Physiol. C Toxicol. Pharmacol. 225, 108563 (2019).
- 9. . Usefulness of lactate dehydrogenase and its isoenzymes as indicators of lung damage or inflammation. Eur. Respir. J. 9(8), 1736–1742 (1996).
- 10. Lactate dehydrogenase as an indicator of severe illness in neonatal intensive care patients: a longitudinal cohort study. Acta Paediatr. 101(12), 1225–1231 (2012).
- 11. . Lactate dehydrogenase is the key enzyme for pneumococcal pyruvate metabolism and pneumococcal survival in blood. Infect. Immun. 82(12), 5099–5109 (2014).
- 12. Intestinal ischemia-reperfusion-induced acute lung injury and oncotic cell death in multiple organs. Shock 28(2), 227–238 (2007).
- 13. . The actual role of LDH as tumor marker, biochemical and clinical aspects. Adv. Exp. Med. Biol. 867, 115–124 (2015).
- 14. Examining the association between serum lactic dehydrogenase and all-cause mortality in patients with metabolic syndrome: a retrospective observational study. BMJ Open 6(5), e011186 (2016).
- 15. High levels of serum lactate dehydrogenase correlate with the severity and mortality of idiopathic pulmonary arterial hypertension. Experiment. Therapeut. Med. 9(6), 2109–2113 (2015).
- 16. . Prognostic value of lactate dehydrogenase for mid-term mortality in acute decompensated heart failure: a comparison to established biomarkers and brain natriuretic peptide. Heart Lung Circ. 29(9), 1318–1327 (2020).
- 17. Lactate dehydrogenase is associated with 28-day mortality in patients with sepsis: a retrospective observational study. J. Surg. Res. 228, 314–321 (2018).
- 18. A retrospective review of intensive care management of organophosphate insecticide poisoning: single center experience. Nigerian J. Clin. Pract. 18(5), 644–650 (2015).
- 19. Clinical course, treatment and outcome of Pneumocystis pneumonia in immunocompromised adults: a retrospective analysis over 17 years. Crit. Care 22(1), 307 (2018).
- 20. Risk factors for mechanical ventilation in patients with scrub typhus admitted to intensive care unit at a university hospital. Tuberculosis Respir. Dis. 79(1), 31–36 (2016).
- 21. PhysioBank, PhysioToolkit and PhysioNet: components of a new research resource for complex physiologic signals. Circulation 101(23), E215–E220 (2000).
- 22. . The eICU Collaborative Research Database, a freely available multi-center database for critical care research. Sci. Data 5, 180178 (2018).
- 23. . Lactate dehydrogenase and cell injury. Cell Biochem. Function 2(3), 144–148 (1984).
- 24. Serum LDH level may predict outcome of chronic lymphocytic leukemia patients with a 17p deletion: a retrospective analysis of prognostic factors in China. Chinese J. Cancer Res. 29(2), 156–165 (2017).
- 25. . [Prognostic importance of lactate dehydrogenase (LDH) in oncology]. Orvosi Hetilap. 158(50), 1977–1988 (2017).
- 26. . Lactate dehydrogenases as metabolic links between tumor and stroma in the tumor microenvironment. Cancers 11(6), 750 (2019).
- 27. . Elevated lactate dehydrogenase (LDH) can be a marker of immune suppression in cancer: interplay between hematologic and solid neoplastic clones and their microenvironments. Cancer Biomark. 19(4), 353–363 (2017).
- 28. . The combined use of three widely available biochemical markers as predictor of organ failure in critically ill patients. Scand. J. Clin. Lab. Invest. 76(6), 479–485 (2016).
- 29. . Sepsis and septic shock. Lancet 392(10141), 75–87 (2018).
- 30. Severity of illness assessment with application of the APACHE IV predicted mortality and outcome trends analysis in an academic cardiac intensive care unit. J. Crit. Care 50, 242–246 (2019).