Nomogram Models to Predict Postoperative Hyperlactatemia in Patients Undergoing Elective Cardiac Surgery

Area of Science:

• Cardiology
• Critical Care Medicine
• Surgical Outcomes

Background:

• Postoperative hyperlactatemia (POHL) is a frequent complication in cardiac surgery patients.
• POHL is associated with adverse clinical outcomes and increased mortality.
• Effective prediction of POHL is crucial for timely intervention and improved patient management.

Purpose of the Study:

• To develop and validate predictive models for POHL in patients undergoing elective cardiac surgery (ECS).
• To identify key risk factors associated with POHL development.
• To create nomograms for clinical utility in risk estimation and stratification.

Main Methods:

• A multicenter retrospective study of 13,454 adult patients undergoing ECS.
• Patients were randomly assigned to training and validation cohorts.
• Univariate and multivariate analyses identified independent predictors for nomogram construction.

Main Results:

• 10.6% of patients developed POHL.
• Independent predictors included age, ejection fraction, renal insufficiency, prior cardiac surgery, red blood cell transfusion, and cardiopulmonary bypass time.
• Two nomograms demonstrated good predictive ability, calibration, and clinical utility for risk stratification into four groups.

Conclusions:

• Two validated nomogram models effectively predict POHL in ECS patients.
• These nomograms offer clinical utility for risk assessment, stratification, and guiding targeted interventions.
• The models can assist clinicians in managing patients at risk for POHL.