The relationship between metabolic acidosis as a predictive factor of mortality in Ludwig's Angina patients at Dr. Soetomo General Hospital, Surabaya, Indonesia

Abstract

Background: Mortality in a patient with Ludwig's Angina is usually due to prolonged sepsis. When sepsis is present, acidosis and lactate independently predict mortality in critically ill patients. Patients who develop acidosis after 6 hours are at high risk of death and should be treated more aggressively than septic patients. Methods: A retrospective cohort study to determine the association between metabolic acidosis and mortality in Ludwig's Angina patient at Dr. Soetomo General Hospital Surabaya at Dr. Soetomo between January 2019 - December 2020. We retrospectively reviewed 42 medical records of patients with Ludwig's Angina. We collected patient data such as age, history, physical examination, blood gas analysis, surgical intervention, comorbidities, complications before surgery, and patient outcomes. Results: We analyze a total of 42 patients. 71.40% were male, and 38.60% were in the group of 51-60 years, with a mean age of 45.73 years. 59.50% had metabolic acidosis, and 83.30% died. Based on the comorbidities, there were 28.60% with diabetes mellitus, 21.40% with dental caries and 16.70% with hypertension. A complication of hypoalbuminemia was found in 42.90%, 23.80% with sepsis, and 21.40% with acute kidney injury. Metabolic acidosis and mortality had a significant relationship with a p-value of 0.047, OR 5.00 (95% CI, 0.933-26.785). No comorbidity or complication variables impacted patient outcomes (p > 0.05 for all). Conclusion: There was a significant relationship between metabolic acidosis and mortality of Ludwig's angina patients.