title: Postoperative Lactate Levels and Hospital Length of Stay After Cardiac Surgery.
abstract: OBJECTIVE
  The objective of this study was to characterize the association between lactate levels and hospital length of stay (LOS) after cardiac surgery.
  
  
  METHODS
  A retrospective study using prospectively collected data from the Society of Thoracic Surgeons adult cardiac surgery database.
  
  
  METHODS
  A tertiary-care hospital.
  
  
  METHODS
  Patients in the database who presented for major cardiac surgery between 2002 and 2014 and whose lactate level was measured within 3 hours after skin closure.
  
  
  METHODS
  None.
  
  
  RESULTS
  The authors performed multivariable linear regression with adjustment for more than 30 variables to assess the association between postoperative lactate levels and hospital LOS. The study included 1,208 patients whose median LOS was 6 days (quartiles: 5, 9). Median LOS in the low-, moderate-, and high-lactate groups was 5 days (quartiles: 4, 7), 6 days (quartiles: 5, 9) and 9 days (quartiles: 6, 17), respectively; p<0.001. In multivariable analysis, patients with a moderate lactate level had a 1.08 times (95% CI: 1.00-1.17; p = 0.04) longer LOS compared with those with a low lactate level. Patients with a high lactate level had a 1.12 times (95% CI: 1.00-1.26; p = 0.04) longer LOS compared with those with a low lactate level. Lactate levels also were associated with intensive care unit LOS and nonsurgical postoperative complications.
  
  
  CONCLUSIONS
  Postoperative lactate levels are associated with increased hospital LOS for patients undergoing major cardiac surgery.
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA; Department of Anesthesiology, Aarhus University Hospital, Denmark. Electronic address: lwandersen@clin.au.dk.
authors.forename: Lars W
authors.initials: LW
authors.lastname: Andersen
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA; Research Center for Emergency Medicine, Aarhus University Hospital, Denmark.
authors.forename: Mathias J
authors.initials: MJ
authors.lastname: Holmberg
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery.
authors.forename: Michelle
authors.initials: M
authors.lastname: Doherty
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery.
authors.forename: Kamal
authors.initials: K
authors.lastname: Khabbaz
authors.affiliation: Department of Anesthesia, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Adam
authors.initials: A
authors.lastname: Lerner
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Berg
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Donnino
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000639:trends*; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D007902:Length of Stay / Q000639:trends*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D019344:Lactic Acid
keywords: cardiac surgery; coronary artery bypass grafting; lactate; length of stay; morbidity; valve surgery