Lactate Albumin Ratio as Predictor of 28 Days Mortality in Septic Shock Patients and its Correlation to SOFA Score for Assessment of Organ Dysfunction: A Prospective Observational Study

Abstract

Background: Sepsis and septic shock are leading cause of mortality in ICU patients. Prognostication and early intervention forms most integral part of management of septic shock. There many validated score to assess the critical state of septic shock patients. APACHE2 and SOFA scores are widely used world over. Multiple parameters used in the score and complexity involved have lead researchers to search for more convenient and simple markers. Lactate albumin Ratio (L/A ratio) turns out to be one such marker, combining two easily available parameters and abbreviating fallacies associated with both parameters when assessed individually. We aimed to assess L/A ratio as predictor of all cause 28 days’ mortality in septic shock patients and correlated L/A ratio to the SOFA score to assess organ dysfunction.
 Methods: It was a prospective observational study. 130 patients admitted in the state of septic shock were studied. L/A ratio was obtained at 24 hours after admission in the ICU. SOFA score was also calculated at 24 hours. ROC curve was plotted for L/A ratio to evaluate diagnostic accuracy, as predictor of 28 days’ mortality. Multivariable analysis of L/A ratio with other significant parameters was performed. Spearman rank correlation coefficient was used for correlation of L/A ratio with SOFA score.
 Results: L/A ratio at 24 hours (AUC 0.99; 95% CI: 0.95 to 0.99), p value =0.0001, was significant predictor of mortality at 28 days, at cut off point of >1.15. Significant positive correlation was found between L/A ratio and SOFA score at 24 hours, with correlation coefficient of 0.828, p value=0.0001.
 Conclusion: L/A ratio was found to be independent predictor of 28 days’ Mortality in Septic Shock Patients. Also strong correlation was obtained of L/A ratio to SOFA score to assess organ dysfunction in septic shock patients.