Lactic Acid Level as A Predictor of Severity in Patients with Acute Appendicitis

Raka Aditya, Reno Rudiman, Putie Hapsari

Abstract


Perforated appendicitis is the leading cause of morbidity and mortality of all appendicitis cases in adults and children, with delayed preoperative diagnosis as the main reason. In previous studies, diagnostic modalities such as radiological examination and the current scoring system have been demonstrated as unable to predict the onset of perforated appendicitis. Serological biomarkers of lactic acid are associated with intestinal obstruction and ischemia. The serological value of lactic acid in identifying perforated appendicitis compared to acute one was shown to increase significantly by 0.25 mmol/L (p<0.05) in a previous study. This study aimed to determine the correlation between lactic acid and the severity of appendicitis. This was a cross-sectional prospective analytic observational study in patients treated in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Subjects were adult patients diagnosed with appendicitis during the period of 2021 in the Emergency Room of the hospital. Data were analyzed using the bivariate analysis and correlation test of difference. This study involved 54 subjects, divided into the complicated appendicitis (study) and control groups, with a mean of lactic acid level of 2,5093 mmol/L (0.9 mmol/L–11.8 mmol/L). In the complicated appendicitis group, 20 subjects (37%) demonstrated an increase in lactic acid level (OR 1.07; 95% CI: -0.03–0.22; p=0.14). The correlation analysis resulted in a negative correlation. This study concluded that there is no significant correlation between lactic acid levels and the severity of appendicitis in these patients.

Keywords


Correlation, lactic acid, perforated appendicitis

Full Text:

PDF

References


  1. Chambers D, Huang C, Matthews G. Schwartz’s Principals of Surgery.11th ed. New York; McGraw Hill; 2019. p.1241-1259.
  2. Ferris M, Quan S, Kaplan BS, Molodecky N, Ball CG, Chernoff GW.et al. The global incidence of appendicitis. Ann Surg. 2017; 266(2):237–41.
  3. Nazir MS, Parveen N, Anjum S, Nadeem N, Sohail H, Sohail M.et al. Diagnostic accuracy of lactate and c-reactive protein in patients with acute appendicitis. Pakistan J Med Heal Sci. 2020; 14(3):540–2.
  4. Kim TH, Cho BS, Jung JH, Lee MS, Jang JH, Kim CN. Predictive factors to distinguish between patients with noncomplicated appendicitis and those with complicated appendicitis. Ann Coloproctol. 2015;31(5):192–7.
  5. Montagnana M, Danese E, Lippi G. Biochemical markers of acute intestinal ischemia: possibilities and limitations. Ann Transl Med. 2018;6(17):341.
  6. Shi H, Wu B, Wan J, Liu W, Su B. The role of serum intestinal fatty acid binding protein levels and D-lactate levels in the diagnosis of acute intestinal ischemia. Clin Res Hepatol Gastroenterol. 2015. 39(3):373–8
  7. Afaque MY, Rehman N, Rizvi SAA, Ahmed M. Early Recognition and Management of Small Bowel Perforation. In: Goenka M, Goenka U, Rodge GA, eds. Endoscopy in Small Bowel Diseases. Intech Open. 2021. 3(8):1–8.
  8. Nazir MS, Parveen N, Anjum S, Nadeem N, Sohail H, Sohail M, Sulehri AA. Diagnostic Accuracy of Lactate and C-reactive Protein in patients with acute appendicitis. Pakistan Journal of Medical & Health Sciences. 2020; 14(3):540–42.
  9. Lee J, Byun Y, Park J, Lee J, Ryu J, Choi S. Lactic acid level as an outcome predictor in pediatric patients with intussusception in the emergency department. BMC Pediatrics Journal. 2020; 184(20):1–10.
  10. Virmani S, Prabhu PS, Sundeep PT, Kumar V. Role of laboratory markers in predicting severity of acute appendicitis. African J Paediatr Surg. 2018;15(1):1–4.




DOI: https://doi.org/10.15395/mkb.v56.3086

Article Metrics

Abstract view : 114 times
PDF - 54 times

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


 


Creative Commons License
MKB is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 


View My Stats