Investigation of Lactate, Base Excess, and Alactic Base Excess in Patients With Upper Gastrointestinal Bleeding.

Abstract

Introduction: Gastrointestinal system (GIS) bleeding is one of the most common reasons for emergency department visits. The aim of this study is to investigate the impact of base excess, lactate, and alactic base excess-parameters that can be quickly assessed through blood gas analysis-on predicting the clinical outcome in patients presenting to the emergency department with GIS bleeding.

Materials and methods: The study was retrospective and conducted at a single center from January 1 to December 31, 2022. The collected data included age, gender, blood gas (lactate and base excess), and outcomes (discharge, intensive care, and death).

Results and conclusions: The study included 205 patients (135 males and 70 females). Deceased individuals had a lower average base excess and higher lactate levels. There were no significant differences in ward admission based on alactic base excess status. A base excess cutoff value of ≥ -0.65 was used to predict ward admission, yielding a sensitivity of 57.71%, specificity of 63.33%, PPV of 90.18%, and negative predictive value of 20.43%. According to the data obtained in our study, we observed that a lactate cutoff value ≥ 2.07 could be effective in predicting ICU admission for patients. We also found that a base excess cutoff value ≥ -0.65 could be effective in predicting admission to the ward. The mean base excess was lower in patients who resulted in death compared to survivors, while the mean lactate level was higher. However, no significant result was found regarding alactic base excess.