Assessing Predictive Value of Postoperative Elevated Lactate for Adverse Outcomes Following Hepatectomy
- 88 Downloads
To the Editor,
With great interest, we read the recent article by Lemke et al.  determining the association of early post-hepatectomy lactate (PHL) with adverse outcomes. They show that PHL is independently associated with postoperative 90-day mortality and 30-day morbidity. As lactate increases from < 2 to > 6 mmol/L, 30-day morbidity rises from 11.6 to 40.6%, and 90-day mortality from 0.7 to 22.7%. Furthermore, the cutoff values of PHL for predicting morbidity and mortality are 3.96 and 3.72 mmol/L, respectively. Other than the limitations described in the discussion, however, we note that several issues of this study are not well addressed.
First, to determine discrimination ability of elevated PHL for postoperative morbidity and mortality, only providing odds ratio by multivariable analysis and cutoff values by the receiver operating characteristic curve is not enough. The authors should further provide the sensitivity, specificity, positive, and negative predictive values of...
Compliance with ethical standards
Conflict of interest
All authors have no financial support and potential conflicts of interest for this work.
- 4.Meguro M, Mizuguchi T, Kawamoto M, Nishidate T, Ishii M, Tatsumi H et al (2014) Highest intraoperative lactate level could predict postoperative infectious complications after hepatectomy, reflecting the Pringle maneuver especially in chronic liver disease. J Hepatobiliary Pancreat Sci 21(7):489–498CrossRefPubMedGoogle Scholar