Lactate/Albumin Ratio as a Predictor of In-Hospital Mortality in Septic Patients Presenting to the Emergency Department
Ralphe Bou Chebl, Sarah Jamali, Mohamad Sabra, Rawan Safa, Iskandar Berbari, Ali Shami, Maha Makki, Hani Tamim, Gilbert Abou Dagher
Abstract
Background: The aim of this study is to evaluate the prognostic value of the 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 1381 patients were included, 44% were female and their mean age was 71.2 years old. Overall in-hospital mortality was 58.4% and 55.5% 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.