Admission lactate concentration has predictive value for death or severe complications within 30 days after admission in cattle with long-bone fractures

Caroline Constant AO Research Institute Davos, Davos, Switzerland
Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, QC, Canada

Search for other papers by Caroline Constant in
Current site
Google Scholar
PubMed
Close
 DMV, MSc, MENG, DACVS-LA, DECVS
,
Emma Marchionatti Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, QC, Canada
Clinic for Ruminants, Vetsuisse Faculty, University of Bern, Bern, Switzerland

Search for other papers by Emma Marchionatti in
Current site
Google Scholar
PubMed
Close
 DMV, MSc, DACVS-LA, DECVS
,
André Desrochers Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, QC, Canada

Search for other papers by André Desrochers in
Current site
Google Scholar
PubMed
Close
 DMV, MS, DACVS, DipECBHM
,
Marie Babkine Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, QC, Canada

Search for other papers by Marie Babkine in
Current site
Google Scholar
PubMed
Close
 DMV, MSc, DipECBHM
, and
Sylvain Nichols Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, QC, Canada

Search for other papers by Sylvain Nichols in
Current site
Google Scholar
PubMed
Close
 DMV, MS, DACVS

Click on author name to view affiliation information

Abstract

OBJECTIVE

To determine the prognostic value of lactate concentration measurements at admission in cattle with long-bone fractures.

ANIMALS

43 cattle with long-bone fractures between July 2016 and Dec 2018.

PROCEDURES

In this prospective cohort study, lactate concentration was measured in systemic venous blood and locally in capillary blood sampled from the fractured and contralateral limbs of cattle and assessed for outcome prediction. The cutoff value was determined by maximizing the Youden index from receiver-operating characteristic curves. Multivariable logistic regression was employed to verify whether higher lactate concentrations compared with the cutoff value were an independent risk factor for poor outcomes at 30 days or 3 years after admission.

RESULTS

Poor outcome was associated with higher capillary lactate concentration in the fractured limb (P < .001) and greater difference with systemic blood (P = .005). A cutoff value of lactate difference ≥ 2.4 mmol/L (sensitivity = 0.80; specificity = 0.965) between capillary lactate in the fractured limb and systemic blood was the best predictor of death ≤ 30 days after admission (P < .001). Multivariable analysis revealed that this cutoff value was an independent risk factor for 30-day and 3-year outcomes (P < .001).

CLINICAL RELEVANCE

Admission blood lactate concentration difference ≥ 2.4 mmol/L between the fractured limb and systemic blood was a robust and independent predictor of outcome for cattle of the present report. Lactate metabolism is locally impaired in fractured limbs of nonsurviving or at higher complication risk cattle, which may help identify patients at high risk for poor outcomes.

Abstract

OBJECTIVE

To determine the prognostic value of lactate concentration measurements at admission in cattle with long-bone fractures.

ANIMALS

43 cattle with long-bone fractures between July 2016 and Dec 2018.

PROCEDURES

In this prospective cohort study, lactate concentration was measured in systemic venous blood and locally in capillary blood sampled from the fractured and contralateral limbs of cattle and assessed for outcome prediction. The cutoff value was determined by maximizing the Youden index from receiver-operating characteristic curves. Multivariable logistic regression was employed to verify whether higher lactate concentrations compared with the cutoff value were an independent risk factor for poor outcomes at 30 days or 3 years after admission.

RESULTS

Poor outcome was associated with higher capillary lactate concentration in the fractured limb (P < .001) and greater difference with systemic blood (P = .005). A cutoff value of lactate difference ≥ 2.4 mmol/L (sensitivity = 0.80; specificity = 0.965) between capillary lactate in the fractured limb and systemic blood was the best predictor of death ≤ 30 days after admission (P < .001). Multivariable analysis revealed that this cutoff value was an independent risk factor for 30-day and 3-year outcomes (P < .001).

CLINICAL RELEVANCE

Admission blood lactate concentration difference ≥ 2.4 mmol/L between the fractured limb and systemic blood was a robust and independent predictor of outcome for cattle of the present report. Lactate metabolism is locally impaired in fractured limbs of nonsurviving or at higher complication risk cattle, which may help identify patients at high risk for poor outcomes.

Supplementary Materials

    • Supplementary Figure S1 (PDF 123 KB)
All Time Past Year Past 30 Days
Abstract Views 388 0 0
Full Text Views 842 504 93
PDF Downloads 720 408 27
Advertisement