BACKGROUND: Serum lactate dehydrogenase (LDH) is elevated in various diseases. OBJECTIVES: To analyze serum LDH as a distinguishing clinical biomarker and as a predictor of in-hospital outcome in admitted medical patients. METHODS: We analyzed a cohort of all 158 patients with very high isolated LDH (LDH > or = 800 IU/ml without concomitant elevations of alanine aminotransferase and aspartate aminotransferase) admitted to our internal medicine department during a 3 year period. Epidemiologic and clinical data, as well as the final diagnosis and outcome were recorded and compared with those of a cohort of all 188 consecutive control patients. RESULTS: Very high isolated LDH was a distinguishing biomarker for the presence of cancer (27% vs. 4% in the LDH group and controls respectively, P < 0.0001), liver metastases (14% vs. 3%, P < 0.0001), hematologic malignancies (5% vs. 0%, P = 0.00019), and infection (57% vs. 28%, P < 0.0001). Very high isolated LDH was a marker for severe prognosis, associated with more admission days (9.3 vs. 4.1, P < 0.0001), significantly more in-hospital major complications, and high mortality rate (26.6% vs. 4.3%, P < 0.0001). Finally, very high isolated LDH was found in a multivariate regression analysis to be an independent predictor of mortality. CONCLUSIONS: The presence of very high isolated LDH warrants thorough investigation for the presence of severe underlying disease, mostly metastatic cancer, hematologic malignancies, and infection. Moreover, it is a marker for major in-hospital complications and is an independent predictor of mortality in admitted medical patients. lactate dehydrogenase (LDH), cancer, internal medicine
BACKGROUND: Serum lactate dehydrogenase (LDH) is elevated in various diseases. OBJECTIVES: To analyze serum LDH as a distinguishing clinical biomarker and as a predictor of in-hospital outcome in admitted medical patients. METHODS: We analyzed a cohort of all 158 patients with very high isolated LDH (LDH > or = 800 IU/ml without concomitant elevations of alanine aminotransferase and aspartate aminotransferase) admitted to our internal medicine department during a 3 year period. Epidemiologic and clinical data, as well as the final diagnosis and outcome were recorded and compared with those of a cohort of all 188 consecutive control patients. RESULTS: Very high isolated LDH was a distinguishing biomarker for the presence of cancer (27% vs. 4% in the LDH group and controls respectively, P < 0.0001), liver metastases (14% vs. 3%, P < 0.0001), hematologic malignancies (5% vs. 0%, P = 0.00019), and infection (57% vs. 28%, P < 0.0001). Very high isolated LDH was a marker for severe prognosis, associated with more admission days (9.3 vs. 4.1, P < 0.0001), significantly more in-hospital major complications, and high mortality rate (26.6% vs. 4.3%, P < 0.0001). Finally, very high isolated LDH was found in a multivariate regression analysis to be an independent predictor of mortality. CONCLUSIONS: The presence of very high isolated LDH warrants thorough investigation for the presence of severe underlying disease, mostly metastatic cancer, hematologic malignancies, and infection. Moreover, it is a marker for major in-hospital complications and is an independent predictor of mortality in admitted medical patients. lactate dehydrogenase (LDH), cancer, internal medicine
Authors: Ronald B Reisler; Chenggang Yu; Michael J Donofrio; Travis K Warren; Jay B Wells; Kelly S Stuthman; Nicole L Garza; Sean A Vantongeren; Ginger C Donnelly; Christopher D Kane; Mark G Kortepeter; Sina Bavari; Anthony P Cardile Journal: Emerg Infect Dis Date: 2017-08 Impact factor: 6.883
Authors: Brandon Michael Henry; Gaurav Aggarwal; Johnny Wong; Stefanie Benoit; Jens Vikse; Mario Plebani; Giuseppe Lippi Journal: Am J Emerg Med Date: 2020-05-27 Impact factor: 2.469
Authors: Dipnarine Maharaj; Pedro G Vianna; Wendy Ward; Anthony J Messina; Trevor Rayborn; Jacqueline V Gouvea; Richard D Hammer; Zheng Cui Journal: Heliyon Date: 2017-10-31