The Association of Serum Lactate Dehydrogenase Levels with In- Hospital Mortality due to Pulmonary Embolism

A significant correlation exists between elevated lactate dehydrogenase (LDH) levels and thrombotic events, yet the prognostic value of this biomarker in patients with pulmonary embolism (PE) remains elusive. Finding new biomarkers can help us achieve better risk stratification and treatment strategies to reduce the mortality of PE patients.

We aimed to determine the possible association between serum LDH and the in-hospital mortality of PE patients.

In this cross-sectional study, 217 patients with PE (diagnosed by computed tomography angiography) and a serum LDH level documented within the first 24 hours of admission were included. Our exclusion criteria were hepatic and renal diseases, pregnancy, hemolytic disorders, left ventricular infarction, recent stroke, positive history of active cancer, acute and chronic infections, and reticuloendothelial-related diseases.

The mean age of patients was 63.04 ± 16.81 years; 23 patients (10.6%) died during hospitalization. Multivariate analysis showed that LDH and white blood cells (WBC) were independent predictors of in-hospital mortality; however, this association was insignificant. Univariate analysis showed that higher levels of LDH, WBC, and red cell distribution width (RDW) had a significant association with in-hospital mortality (P < 0.05). The receiver operating characteristics curve showed that an LDH cut-off value of 515 U/l had a sensitivity of 91.3% and specificity of 45.9% in predicting in-hospital mortality (95% CI = 0.636 – 0.761, P = 0.0003).

LDH can be an excellent prognostic marker for predicting in-hospital death in patients with pulmonary embolism.