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%
