RELATIONSHIP OF SERUM LACTATE LEVEL WITH MORTALITY AND AMPUTATION IN ACUTE LİMB ISCHEMIA

Aim; Acute limb ischemia (ALI) is a vascular emergency characterized by sudden limb perfusion failure, which may lead to amputation or mortality if not treated promptly. This study investigates the relationship between preoperative serum lactate levels and amputation and in-hospital mortality in ALI patients undergoing emergency embolectomy. Method; A retrospective analysis was conducted on 67 patients treated at Konya City Hospital between 2021 and 2023. Patients with chronic peripheral arterial disease, chronic renal failure, or missing preoperative lactate data were excluded. Demographic information, comorbidities, motor-sensory deficits, Rutherford classification, biochemical parameters, and 30-day postoperative outcomes were analyzed. Logistic regression was performed to determine risk factors for amputation and mortality. Results; Diabetes mellitus (DM), motor deficits, sensory deficits, and Rutherford category IIB were significantly associated with amputation. However, in multivariate analysis, only DM remained a significant predictor (OR: 4.923, p=0.042). Serum lactate levels showed no significant association with amputation but were significantly higher in patients who died in-hospital (median 4.1 vs. 2.15, p=0.002). Univariate analysis confirmed that elevated lactate levels increased mortality risk (OR: 2.354, p=0.003). Creatine kinase (CK) levels were also higher in both amputated and deceased patients, though significance was lost in multivariate analysis. Conclusion; Preoperative serum lactate levels are significantly associated with in-hospital mortality but not amputation. DM is a strong independent predictor of amputation. Further studies with larger sample sizes are needed to validate these findings.