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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Early lactate levels after aneurysmal subarachnoid hemorrhage correlate with functional neurological outcome – a single center series

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  • Tamara Yasmin Kern - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Patrick Schuss - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Alexis Hadjiathanasiou - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Simon Brandecker - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Erdem Güresir - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV196

doi: 10.3205/18dgnc199, urn:nbn:de:0183-18dgnc1999

Published: June 18, 2018

© 2018 Kern et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: High lactate levels are known predictors of poor outcome in critically ill patients. However, the potential contribution of early lactate in patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) to neurological outcome is sparse. Therefore, we analyzed our neurovascular database to assess the relationship between early lactate levels and functional outcome after aSAH.

Methods: 376 patients with aSAH were treated between January 2011 and December 2016. Information, including patient characteristics, treatment modality, aneurysm size and location, laboratory values, radiological features and functional neurological outcome were assessed and further analyzed. Patients suffering from aSAH were divided into "low lactate on admission" (lactate <2.0 mmol/l) and "high lactate on admission" (lactate ≥2.0 mmol/l). The outcome was assessed according to the modified Rankin Scale (mRS) at 6 months and stratified into favourable (mRS 0-2) versus unfavourable (mRS 3-6).

Results: Patients with aSAH and initial lactate levels <2.0 mmol/l were significantly more likely to achieve a favourable outcome compared to patients with lactate levels ≥2.0 mmol/l (82% vs. 18%; p<0.001). Patients suffering from poor-grade aSAH had significantly higher levels of initial lactate, when compared to patients with good-grade aSAH (p=0.004). In the multivariate analysis, lactate levels ≥2mmol/l (p=0.04, OR 2, 95% CI 1-3.9), and poor grade patients (WFNS IV-V, p=0.001, OR 8.9, 95% CI 5.4-15) were independent predictors of unfavourable outcome.

Conclusion: Elevated lactate levels are independently associated with unfavourable functional neurological outcome in aSAH.