Abstract

Background: The aim of this study is to evaluate the prognostic value of the Lactate to Albumin (L/A) ratio compared to that of lactate only in predicting morbidity and mortality in sepsis patients.Methods: This was a single-center retrospective cohort study. All adult patients above the age of 18 with a diagnosis of sepsis who presented between January 1, 2014 and June 30, 2019 were included. The primary outcome was in-hospital mortality.Results: A total of 1,381 patients were included, 44% were female. Overall in-hospital mortality was 58.4% with the mortalities of sepsis and septic shock being 45.8 and 67%, respectively. 55.5% of patients were admitted to the intensive care unit. The area under the curve value for lactate was 0.61 (95% CI 0.57–0.65, p < 0.001) and for the L/A ratio was 0.67 (95% CI 0.63–0.70, p < 0.001). The cutoff generated was 1.22 (sensitivity 59%, specificity 62%) for the L/A ratio in all septic patients and 1.47 (sensitivity 60%, specificity 67%) in patients with septic shock. The L/A ratio was a predictor of in-hospital mortality (OR 1.53, CI 1.32–1.78, p < 0.001).Conclusion: The L/A ratio has better prognostic performance than initial serum lactate for in-hospital mortality in adult septic patients.

Highlights

  • BackgroundSepsis remains a major burden worldwide, with a global estimate of 31.5 million cases and 5.3 million deaths per year [1]

  • Overall in-hospital mortality was 58.4% with the mortalities of sepsis and septic shock being 45.8 and 67%, respectively. 55.5% of patients were admitted to the intensive care unit

  • The lactate to albumin (L/A) ratio was a predictor of in-hospital mortality

Read more

Summary

Introduction

BackgroundSepsis remains a major burden worldwide, with a global estimate of 31.5 million cases and 5.3 million deaths per year [1]. Lactic acidosis has been described in patients on metformin and albuterol [13], patients with diabetic ketoacidosis [14], malignancies [15], intoxication [16], hepatic or renal dysfunction [17, 18], and lastly, as a consequence of receiving epinephrine [13] In these cases, it is challenging to rely solely on lactate levels for prognostication. Given the limitations of lactate and the need for a surrogate marker of disease severity, a growing body of literature has found this ratio to be predictive of mortality and multiple organ failure in critically-ill patients with sepsis [7, 21, 22]. The aim of this study is to evaluate the prognostic value of the Lactate to Albumin (L/A) ratio compared to that of lactate only in predicting morbidity and mortality in sepsis patients

Objectives
Methods
Results
Discussion
Conclusion

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.