AUTHOR=Bou Chebl Ralphe , Jamali Sarah , Sabra Mohamad , Safa Rawan , Berbari Iskandar , Shami Ali , Makki Maha , Tamim Hani , Abou Dagher Gilbert 

TITLE=Lactate/Albumin Ratio as a Predictor of In-Hospital Mortality in Septic Patients Presenting to the Emergency Department

JOURNAL=Frontiers in Medicine

VOLUME=7

YEAR=2020

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2020.550182

DOI=10.3389/fmed.2020.550182

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> 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.</p><p><bold>Methods:</bold> 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.</p><p><bold>Results:</bold> 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, <italic>p</italic> &lt; 0.001) and for the L/A ratio was 0.67 (95% CI 0.63–0.70, <italic>p</italic> &lt; 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, <italic>p</italic> &lt; 0.001).</p><p><bold>Conclusion:</bold> The L/A ratio has better prognostic performance than initial serum lactate for in-hospital mortality in adult septic patients.</p>