Centenarian Lactate

First Author(s)

• AJ

  Anja Kathrin Jaehne, MD

  Henry Ford Hospital
  Detroit, MI

  Disclosure information not submitted.

  Slides and Audio

Co-Author(s)

• WD

  William Dobson, BS

  Principal Performance Management Analyst
  Henry Ford Hospital
  Detroit, Michigan, United States

  Disclosure information not submitted.
• GM

  Gregory Maruca, BS, ITIL

  Principal Performance Management Analyst
  Henry Ford Hospital
  Detroit, Michigan, United States

  Disclosure information not submitted.
• ER

  Emanuel Rivers, BS, MD, MPH, IOM

  Physician
  Henry Ford Hospital, United States

  Disclosure information not submitted.

Title: CENTENARIAN LACTATE

Introduction: Based on the WHO data, from 2000 to 2019, global life expectancy has increased by 6 years to 73.4 years. In developed countries, the estimated life expectancy is 79 years for men and 82 years for women. With a higher possibility of people reaching age 100 or older, little is known about the usefulness of lactate (LA) for risk stratification in the population of centenarians.

Methods: We reviewed a deidentified data set from an urban teaching hospital from 01/2000 to 03/2021. LA data for patients age 100 or older at the time of the LA evaluation was grouped into LA levels of < 4 mmol/L and ≥ 4 mmol/L, along with evaluation of lactate clearance (LAC) and mortality.

Results: We identified 388 encounters for patients older than 100 years ranging from 100 to 114 years old (average 102.02±2.04),with increasing trends of LA test utilization from 2000 to 2021. Female patients account for 322, 83% of LA evaluations. Average 1st LA was 2.33±2.0 mmol/L for all patients, ranging from 0.4 to 17.3 mmol/L. Higher 1st LA values were observed in patients with multiple LA draws (2.91±1.75 mmol/L) compared to patient with single LAs (1.98±1.84 mmol/L). Overall, in-hospital mortality was 100, 25.8% with higher mortality in patients with multiple LA draws (45, 37.2%). LA ≥ 4 was present in 39, 10.1% of patients. In-hospital mortality for these patients was 22, 56.7%. LAC was available for 114 patients with average LAC of 26.7±25.8%. LAC < 20% was present in 43 of those patients with an observed in-hospital mortality of 15, 34.9% compared to a mortality of 16, 22.5% in patients with LAC ≥20%.

Conclusion: In centenarians, more female patients are evaluated with LA. LA ≥4 mmol/L indicates high risk of mortality in this age group, similar to the general population. Centenarians that achieve LAC >20% have better chances of surviving to hospital discharge, indicating possible considerations for targeted resuscitation. The results need to be viewed with caution as various confounders are present.