Diagnostic and prognostic value of very high serum lactate dehydrogenase in admitted medical patients

Aharon Erez, Omri Shental, Joseph Z. Tchebiner, Michal Laufer-Perl, Asaf Wasserman, Tal Sella, Hanan Guzner-Gur*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

63 Scopus citations

Abstract

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 ≥ 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.

Original languageEnglish
Pages (from-to)439-443
Number of pages5
JournalIsrael Medical Association Journal
Volume16
Issue number7
StatePublished - Jul 2014

Keywords

  • Cancer
  • Internal medicine
  • Lactate Dehydrogenase (LDH)

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