Lactate/albumin ratio is more effective than lactate or albumin alone in predicting clinical outcomes in intensive care patients with sepsis

Çakır, Esra; Turan, İşıl Özkoçak

doi:10.1080/00365513.2021.1901306

Cited by 35 publications

(49 citation statements)

References 24 publications

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“…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: 68%

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: Discussioncontrasting

confidence: 68%

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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“…https://doi.org/10.1371/journal. pone.0255744 can independently predict the mortality of critically ill patients, such as sepsis [13,14] and severe heart failure [15].…”

Section: Open Accessmentioning

confidence: 99%

“…Serum albumin is a negatively regulated acute inflammatory response protein [ 12 ]. Previous studies have shown that lactate/albumin ratio (LAR) can be used as a better prognostic biomarker and can independently predict the mortality of critically ill patients, such as sepsis [ 13 , 14 ] and severe heart failure [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Association between lactate/albumin ratio and all-cause mortality in patients with acute respiratory failure: A retrospective analysis

Guo

Chen

et al. 2021

PLoS ONE

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Previous studies have shown that lactate/albumin ratio (LAR) can be used as a prognostic biomarker to independently predict the mortality of sepsis and severe heart failure. However, the role of LAR as an independent prognostic factor in all-cause mortality in patients with acute respiratory failure (ARF) remains to be clarified. Therefore, we retrospectively analyzed 2170 patients with ARF in Medical Information Mart for Intensive Care Database III from 2001 to 2012. By drawing the receiver operating characteristic curve, LAR shows a better predictive value in predicting the 30-day mortality of ARF patients (AUC: 0.646), which is higher than that of albumin (AUC: 0.631) or lactate (AUC: 0.616) alone, and even higher than SOFA score(AUC: 0.642). COX regression analysis and Kaplan-Meier curve objectively and intuitively show that high LAR is a risk factor for patients with ARF, which is positively correlated with all-cause mortality. As an easy-to-obtain and objective biomarker, LAR deserves further verification by multi-center prospective studies.

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“…A study by Lichtenauer et al 28 , showed that the L/A ratio contributes to the risk stratification for patients with sepsis. Cakir et al 37 , in their study consisting of 1,136 septic patients showed that L/A ratio has better predictive validity compared to lactate or albumin alone in septic patients.…”

Section: Discussionmentioning

confidence: 98%

Comparison of lactate/albumin ratio to lactate and lactate clearance for predicting outcomes in patients with septic shock admitted to intensive care unit: an observational study

Shadvar

Nader

Vahed

et al. 2022

Sci Rep

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The aim of this study was to evaluate the prognostic value of the Lactate to Albumin (L/A) ratio compared to that of lactate and lactate clearance in predicting outcomes in patients with septic shock. This was a multi-center observational study of adult patients with septic shock, who admitted to intensive care units (ICUs) at Shohada and Imam Reza Hospitals, Tabriz, Iran, between Sept 2018 and Jan 2021. The area under the curve (AUC) of receiver operating characteristic (ROC) curve and multivariate logistic regression analyses were used to explore associations of the L/A ratio, lactate and lactate clearance on the primary (mortality) and secondary outcomes [ICU length of stay (LOS), duration of mechanical ventilation (MV), need of renal replacement therapy (RRT) and duration of using vasopressors] at baseline, 6 h and 24 h of septic shock recognition. Best performing predictive value for mortality were related to lactate clearance at 24 h, L/A ratio at 6 h and lactate levels at 24 h with (AUC 0.963, 95% CI 0.918–0.987, P < 0.001), (AUC 0.917, 95% CI 0.861–0.956, P < 0.001), and (AUC 0.904, 95% CI 0.845–0.946, P < 0.001), respectively. Generally, the lactate clearance at 24 h had better prognostic performance for mortality and duration of using vasopressor. However, the L/A ratio had better prognostic performance than serum lactate and lactate clearance for RRT, ICU LOS and MV duration.

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Lactate/albumin ratio is more effective than lactate or albumin alone in predicting clinical outcomes in intensive care patients with sepsis

Cited by 35 publications

References 24 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

Association between lactate/albumin ratio and all-cause mortality in patients with acute respiratory failure: A retrospective analysis

Comparison of lactate/albumin ratio to lactate and lactate clearance for predicting outcomes in patients with septic shock admitted to intensive care unit: an observational study

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