Clinical Value of the Lactate/Albumin Ratio and Lactate/Albumin Ratio × Age Score in the Assessment of Prognosis in Patients With Sepsis

Chen, Xiaonan; Zhou, Xinjian; Zhao, Hui; Wang, Yanxue; Pan, Hong; Ma, Ke; Xia, Zhi‐Jie

doi:10.3389/fmed.2021.732410

Cited by 17 publications

(18 citation statements)

References 31 publications

(27 reference statements)

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“…In our study, the prognostic accuracy of LAR for 30-day mortality was good, with an AUROC of 0.737 (95% CI 0.656-0.818), similar to those described in other studies (AUROC 0.61 to 0.869) (7,10,13). Bou et al (7), in a study with 1381 patients in the ED, evaluate sensibility and speci city, with poorer results than our study (59% and 62 % vs. 71.1% and 60.8%, respectively for Bou et al and our results).…”

Section: Discussionsupporting

confidence: 89%

“…In-hospital mortality was higher in these studies with ICU patients (42.7% to 62.4% (10,13), compared to our study (9.4%), as well as 28-day mortality in one study in the ED (22.5%) (9), compared to our 30-day mortality (13.2%).…”

Section: Discussioncontrasting

confidence: 67%

“…One emerging sepsis biomarker is lactate to albumin ratio (LAR) (9,10). It has been tested as predictor of mortality in septic patients in the ED (7,9) and ICU (10)(11)(12)(13), as well as patients with heart failure (14), cardiac arrest (15) and acute respiratory failure (16).…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of Lactate/albumin Ratio for Mortality in Patients With Complicated Urinary Tract Infection

Alberola

Eirós

Artero

et al. 2022

Preprint

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Background Lactate to albumin ratio (LAR) is an emerging sepsis biomarker that has been tested for mortality in patients with sepsis of different focus. Our goal is to evaluate the prognostic value of LAR in patients admitted to hospital due to complicated urinary tract infection. Methods Prospective observational study of patients older than 65 years diagnosed with UTI. Area under the ROC curve, sensibility, and specificity to predict 30-day mortality were calculated for LAR, qSOFA and SOFA and compared. Results 341 UTI cases were analyzed. 30-day mortality (20.2% vs. 6.7%, p < 0.001) and longer hospital stay (5 [4–8] vs. 4 [3–7], p 0.018) were associated with LAR ≥ 0.708. LAR has no statistically significant differences compared to qSOFA and SOFA for predicting 30-day mortality (AUROC 0.737 vs. 0.832 and 0.777 respectively, p 0.119 and p 0.496). The sensitivity of LAR was similar to the sensitivity of qSOFA and SOFA (60.8% vs. 84.4% and 82.2, respectively, p 0.746 and 0.837). However, its specificity was lower than the specificity of qSOFA (60.8% vs. 75%, p 0.003), but similar to the specificity of SOFA (60.8% vs. 57.8%, p 0.787). Conclusion LAR has no significant differences with other well-stablished scores in sepsis, such as qSOFA and SOFA, to predict 30-day mortality in patients with complicated UTI.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 67%

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Prognostic Value of Lactate/albumin Ratio for Mortality in Patients With Complicated Urinary Tract Infection

Alberola

Eirós

Artero

et al. 2022

Preprint

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“…The Lac level in patients with sepsis was higher in the death group than in the survival group, suggesting that Lac levels reflect the poor prognosis. [ 33 ] However, in our study, there were no statistical differences between the two groups ( P > .05). Clinically, Lac levels are usually monitored dynamically to assess the perfusion and the patient’s response to treatment and prognosis.…”

Section: Discussioncontrasting

confidence: 72%

The value of NSE to predict ICU mortality in patients with septic shock: A prospective observational study

Zhang

Han

et al. 2022

Medicine

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To investigate the predictive value of neuron-specific enolase (NSE) on intensive care unit (ICU) mortality in patients with septic shock. Seventy-five patients with septic shock hospitalized in the emergency intensive care unit (EICU) of Hebei General Hospital from March 2020 to September 2021 were included, and the patients’ baseline characteristics and laboratory findings were collected. NSE levels on the first and fourth days after admission were retrieved. NSE% [(NSEday1 – NSEday4)/NSEday1 × 100%] and δNSE (NSEday1 – NSEday4) were calculated. The outcome indicator was ICU mortality. The patients were divided into the survivors group (n = 57) and the nonsurvivors group (n = 18). Multivariate analysis was performed to assess the relationship between NSE and ICU mortality. The predictive value of NSE was evaluated using receiver operating characteristic (ROC) curve. There were no significant differences in age, gender, systolic blood pressure (SBP), heart rate (HR), acute physiology and chronic health evaluation II score (APACHE II score), source of infection, and comorbidities between the 2 groups (all P > .05). Interleukin-6 (IL-6), NSE (day1), and NSE (day4) were significantly higher in patients in the nonsurvivors group (all P < .05), and there were no statistical differences in other laboratory tests between the 2 groups (all P > .05). APACHE II score, IL-6, lactate (Lac), total bilirubin (TBil), NSE (day1), and NSE (day4) showed a weak positive correlation with ICU mortality in patients with septic shock (all P < .05). Multivariate logistic regression analysis demonstrated that APACHE II score (odds ratio [OR] = 1.166, 95% confidence interval [95% confidence interval [CI]] 1.005–1.352, P = .042), IL-6 (OR = 1.001, 95% CI 1.000–1.001, P = .003) and NSE (day4) (OR = 1.099, 95% CI 1.027–1.176, P = .006) were independently associated with the ICU mortality of sepsis shock patients. The area under the curve (AUCs) of APACHE II score, IL-6, NSE (day1), and NSE (day4) for predicting prognosis were 0.650, 0.694, 0.758 and 0.770, respectively (all P < .05). NSE(day4) displayed good sensitivity and specificity (Sn = 61.11%, Sp = 91.23%) for predicting ICU mortality with a cutoff value of 25.94 ug/L. High-level NSE (day4) is an independent predictor of ICU mortality in sepsis shock patients, which may become a good alternate option for evaluating sepsis severity. More extensive studies are needed in the future to demonstrate the prognosis value of NSE.

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“…[ 22 ] A new observational study found Lac/Alb was an independent risk factor for death in patients with sepsis, and Lac/Alb × age score was more accurate and convenient for providing a general assessment of prognosis. [ 23 ] This study found that the Lac/Alb could also predict myocardial injury in elderly patients with SCAP (AUC = 0.737, 95% CI 0.620–0.834), which was better than Lac and NLR, but there were no statistical differences between the 3. The diagnostic sensitivity of Lac was 100%, but the specificity was only 40.43%, which limited its clinical application.…”

Section: Discussionmentioning

confidence: 85%

Predictive value of arterial blood lactate/serum albumin ratio for myocardial injury in elderly patients with severe community-acquired pneumonia

Zhang¹,

Li²,

Lv³

et al. 2022

Medicine

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To investigate the predictive value of arterial blood lactate (Lac)/serum albumin (Alb) ratio (Lac/Alb) on myocardial injury in elderly patients with severe community-acquired pneumonia (SCAP). Seventy-two elderly SCAP patients hospitalized in the intensive care unit (ICU) of the emergency department of Hebei General Hospital from March 2020 to March 2021 were included, and the general data and arterial blood Lac and serum Alb levels were collected, and Lac/Alb values were calculated. The patients were divided into myocardial injury group (n = 25) and nonmyocardial injury group (n = 47) according to whether the myocardial injury occurred during their ICU stay, and the predictive value of Lac/Alb on myocardial injury in elderly patients with SCAP was assessed using receiver operating characteristic curve and area under the curve. There were no statistically significant differences in age and gender between the 2 groups (both P > .05), and there were no statistical differences in oxygenation index, procalcitonin, C-reactive protein, lymphocyte count, and Alb levels between the 2 groups (all P > .05). Neutrophil count, neutrophil\lymphocyte ratio, serum creatinine, Lac, and Lac/Alb levels were significantly higher in patients in the myocardial injury group than in the nonmyocardial injury group [13.90 (11.07,19.67) × 10 9 /L vs 10.79 (8.16,14.23) × 10 9 /L, 26.48 (20.07,31.88) vs 17.79 (9.85,27.23), 135.71 (81.50,284.75) μmol/L vs 76.30 (60.30,140.30) μmol/L, 3.0 (2.2,4.5) mmol/L vs 2.1 (1.6,3.1) mmol/L, 1.34 (0.88,2.16) vs 0.78 (0.60,1.12), all P < .05]. Patients in the myocardial injury group had a significantly higher mortality rate in the ICU than in the nonmyocardial injury group (72.0% vs 36.2%, P < .01). Neutrophils, neutrophil/lymphocyte ratio, serum creatinine, Lac, and Lac/Alb showed a weak positive correlation with myocardial injury in patients (all P < .05). The area under the curve of Lac/Alb for predicting myocardial injury in elderly patients with SCAP was 0.737 (95% confidence interval 0.620–0.834), and the sensitivity and specificity of the prediction with 1.21 as the cutoff value were 60.00% and 78.72%, respectively. Lac/Alb has an excellent predictive value for myocardial injury in elderly SCAP patients.

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Clinical Value of the Lactate/Albumin Ratio and Lactate/Albumin Ratio × Age Score in the Assessment of Prognosis in Patients With Sepsis

Cited by 17 publications

References 31 publications

Prognostic Value of Lactate/albumin Ratio for Mortality in Patients With Complicated Urinary Tract Infection

Prognostic Value of Lactate/albumin Ratio for Mortality in Patients With Complicated Urinary Tract Infection

The value of NSE to predict ICU mortality in patients with septic shock: A prospective observational study

Predictive value of arterial blood lactate/serum albumin ratio for myocardial injury in elderly patients with severe community-acquired pneumonia

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