Lactate clearance predicts massive transfusion in upper gastrointestinal bleeding: a single-center retrospective...

Area of Science:

• Critical Care Medicine
• Gastroenterology
• Emergency Medicine

Background:

• Lactate clearance (LC) is a prognostic marker in critically ill patients.
• The predictive value of LC for massive transfusion (MT) in upper gastrointestinal bleeding (UGIB) is not well-established.

Purpose of the Study:

• To evaluate the predictive value of LC for MT requirements in UGIB patients.
• To assess the combined predictive value of LC and the Glasgow-Blatchford score (GBS) for MT in UGIB.

Main Methods:

• Retrospective study of 452 UGIB patients (September 2021-September 2023).
• MT defined as ≥10 units RBC within 24h or ≥4 units within 1h.
• LC calculated as [(Initial lactate - 1-hour lactate)/Initial lactate] × 100.

Main Results:

• 33 patients (7.3%) required MT.
• Lower LC was significantly associated with MT (p < 0.001).
• LC showed an AUC of 0.840 for predicting MT; combined with GBS, AUC improved to 0.880.

Conclusions:

• Reduced LC predicts higher MT likelihood in UGIB patients.
• LC combined with GBS may improve early risk stratification for MT.
• Findings require validation in prospective multicenter studies due to retrospective design.