Lactate clearance during the first 2 hours after hospital admission: A useful biomarker for predicting 30-day mortality in patients with diabetic ketoacidosis

Objective This study assessed whether lactate clearance (LC) during the first 2 hours after admission to the emergency department can be used to predict the 30-day mortality of patients diagnosed with diabetic ketoacidosis (DKA). Material and methods This was a retrospective observational cohort study of patients admitted to the hospital between January 2014 and January 2019. We identified patients with diabetes who had blood gas test results at the time of admission and 2 hours thereafter. We then calculated the LC in these patients. Patients were divided into groups based on mortality and length of stay (LOS). The groups were compared in terms of age, blood gas pH, osmolarity, glucose level, lactate level on admission and 2 hours thereafter, LC, and bicarbonate (HCO3-), blood urea nitrogen, sodium, and potassium levels. Results The overall mortality rate was 7.54% (8/107). Age, pH, osmolarity, the HCO3-, and sodium levels, the lactate level 2 hours after admission, and LC differed significantly between the groups (Mann-Whitney U test, P < .05). LC cut-off values and areas under the curve were significant (P < .05). Receiver operating characteristic analysis indicated an LC cut-off value of 18.6441; the area under the curve was 0.711 (P < .05). Conclusions LC during the first 2 hours after admission is useful for predicting 30-day mortality in patients with diabetic ketoacidosis.