Frequency and Outcomes of Hyperlactatemia After Neurosurgery

Abstract

Objectives. The aim of this study was to evaluate the incidence and significance of elevated serum lactate and its impact on outcome in postoperative neurosurgical patients admitted to neurosurgical intensive care unit (NSICU). Design. This study’s design is a retrospective analysis in a 13-bed NSICU in a tertiary care hospital. A total of 673 patients were screened and 328 patients were included in the study. Methods. Patients were divided into neurosurgery versus nonneurosurgical admissions. Neurosurgical patients were further grouped as brain surgery, spinal surgery, or intracranial vascular surgery. Reason for admission, length of stay, serum lactate levels, and survival were analyzed. Results. The incidence of hyperlactatemia (lactate level ≥2.0 mmol/L) ranged from 67% in the brain tumor group to 33% in the nonneurosurgery group. Mean serum lactates were significantly higher in the brain tumor (3.17 ± 1.99) and spinal surgery groups (2.79 ± 1.51) than in the nonneurosurgery group (1.86 ± 1.10), P < .05, but not in the intracranial vascular surgery group (2.28 ± 1.71), P > .05. The serum lactate level was not significantly associated with survival. Conclusion. Postoperative hyperlactatemia occurs frequently in neurosurgery patients but appears benign.