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Title: Predictors of mortality in Metformin associated lactic acidosis

Category: Toxicology

Keywords: mortality, predictors, MALA, pH, lactate (PubMed Search)

Posted: 2/13/2020 by Hong Kim, MD

 

Metformin associated lactic acidosis (MALA) has a high rate of mortality, ranging from 25% to 50%. Lactate level and acidemia are frequently associated with poor clinical outcome in many disease/medical conditions (e.g. sepsis).

A study investigated, via meta-analysis, if lactate level and pH were predictive of mortality in MALA.

Results

44 studies were identified from PubMed, EMBASE and Web of Science.

170 cases of MALA were included

  • Median age: 68.5 years
  • Median pH: 7.02
  • Median lactate: 14,45 mmol/L
  • Overall mortality: 36.2%

pH and lactate were poor predictors of mortality based upon ROC curve

  • pH: AUC of 0.430
  • lactate: AUC of 0.593

Conclusion

  • MALA was associated with high mortality in this meta-analysis: 36.2%
  • pH and lactate were poor predictors of mortality. 

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