The Relationship of Lactate-Albumin Ratio to Mortality and Length of Stay in Sepsis Patients at ICU Dr.Sardjito General Hospital
Abstract
Background : Sepsis is one of the causes of morbidity and mortality patients hospitalized in the intensive care unit (ICU) which requires early detection and management to predict outcomes. Lactate-albumin ratio has a predictive value of mortality in patient with sepsis that is similar to APACHE II and SOFA scores.
Objective : To determine the relationship between the lactate-albumin ratio and mortality and length of stay patient with sepsis in ICU of Dr. Sardjito Hospital.
Method : Research design using a retrospective cohort observational study by collecting data from the medical records of sepsis patients at ICU of Dr. Sardjito Hospital. Data were calculate the optimal cutoff using the ROC curve. The relationship between lactate-albumin ratio levels and mortality was analyzed using the chi-square test method followed by logistic regression.
Results : The total study subjects were 136 patients. The cut-off value for the Lactate-Albumin ratio in predicting mortality 0,878, sensitivity 73.0 % and specificity 57.1% (AUC = 0,687; 95% CI 0,56-0,81; p=0,007). The cut-off value for the Lactate-Albumin ratio in predicting ICU length of stay 0,878, sensitivity 71,2% and specificity 63,6% (AUC = 0,684; 95% CI 0,53-0,84; p=0,043). Multivariate analysis showed that an increase in the Lactate-Albumin ratio was independent and significant factor as a predictor of mortality (OR=3,43; 95% CI 1,29-9,16; p=0,013) and ICU length of stay (OR=4,33; 95% CI 1,19-15,68; p=0,036).
Conclusion : An increase in the Lactate-Albumin ratio is independently and significantly associated with an increased risk of mortality and length of stay in sepsis patients.
References
Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8): 801–10. Available at: https://apps.who.int/iris/handle/10665/334216 (Accessed: 17 Januari 2023).
Thapa S, Prasad PN, Shakya YM. Serum lactate albumin ratio as a predictor of mortality in severe sepsis and septic shock at Tribhuwan University Teaching Hospital, Kathmandu. Birat J Health Sci. 2017; 2(2), 191–95. Doi: https://doi.org/10.3126/bjhs.v2i2.18525
Arora J, Mendelson AA, Fox-Robichaud A. Sepsis: Network pathophysiology and implications for early diagnosis. Am J Physiol Regul Integr Comp Physiol. 2023; 324(5). Doi; https://doi.org/10.1152/ajpregu.00003.2023.
Gyawali B, Ramakrishna K, Dhamoon AS. Sepsis: The evolution in definition, pathophysiology, and management,” SAGE Open Med. 2019; 7:1-13. doi:10.1177/2050312119835043.
Chebl RB, El Khuri C, Shami A, Rajha E, Faris N, Bachir R, Dagher GA. Serum lactate is an independent predictor of hospital mortality in critically ill patients in the emergency department: a retrospective study. Scand J Trauma Resusc Emerg Med. 2017; 25(1): 1-7. Doi:10.1186/s13049-017-0415-8
Song-Zan Q, Jin D, Chen ZB, Ye YC, Xiang WW, Ye LM, et al. Hypoalbuminemia, a novel prognostic factor for prediction of long-term outcomes in critically ill patients with septic shock. Int J Clin Exp Med, 2019;12(6), 7401–7409. Availabel from https://e-century.us/files/ijcem/12/6/ijcem0093544.pdf.
Albee, Prasad A, Tripathi T, Khan, MJ. Lactate albumin ratio in comparison with lactate to predict outcomes in sepsis and septic shock. Int J Sci Res. 2022;12(3). Doi:10.21275/MR23315193436
Lichtenauer M, Wernly B, Ohnewein B, Franz M, Kabisch B, Muessig J, et al. The lactate/albumin ratio: A valuable tool for risk stratification in septic patients admitted to ICU. Int J of Mol Sci. 2017;18(9): 1–9. Doi:10.3390/ijms18091893.
Erdoğan M, Findikli HA. Prognostic value of the lactate/albumin ratio for predicting mortality in patients with PNEUMOSEPSIS in Intensive Care Units’, Medicine, 2022; 101(4):1-6. Doi:10.1097/md.0000000000028748.
Chebl RB, Jamali S, Sabra M, Safa R, Berbari I, Shami A, et al. Lactate/albumin ratio as a predictor of in-hospital mortality in septic patients presenting to the Emergency Department’, Front Med. 2020; 7:1-11. Doi:10.3389/fmed.2020.550182.
Adegbite BR, Edoa JR, Ndoumba WFN, Mbadinga LBD, Mombo-Ngoma G, Jacob ST. A comparison of different scores for diagnosis and mortality prediction of adults with sepsis in low-and-middle-income countries: A systematic review and meta-analysis’, eClinicalMedicine. 2021; 42:1-9. Doi:10.1016/j.eclinm.2021.101184.
Baihaqi FA, Delarosa DO, Ramadhan R. Rasio laktat/Albumin sebagai prediktor mortalitas pada pasien dengan sepsis dan syok epsiss: Studi meta-analisis’, J Penyakit Dalam Indones. 2022;9(3)146-54. Doi:10.7454/jpdi.v9i3.718.
Yoon SH, Choi B, Eun S, Bae GE, Koo CM, Kim MK. Using the lactate-to-albumin ratio to predict mortality in patients with sepsis or septic shock: A systematic review and meta-analysis. Eur Rev Med Pharmacol Sci. 2022; 26(5):. 1743-752. Doi:10.26355/eurrev_202203_28244.
Altun GT, Arslantas MK, ,Dincer PC, Arslantas R, Karamaz A. Prognostic value of the lactate–albumin difference for predicting in-hospital mortality in critically ill patients with sepsis’, Marmara Med J. 2022; 35(1): 61–6. Doi:10.5472/marumj.1059093.
Shadvar K, Nader-Djalal N, Vahed N, Sanaie S, Iranpour A, Mahmoodpoor A, et al. 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. Sci Rep. 2022; 12(1), 1–12. Doi:10.1038/s41598-022-14764-z.
Shin J, Hwang SY, Jo IJ, Kim WY, Ryoo SM, Kang GH, et al. Prognostic value of the lactate/albumin ratio for predicting 28-day mortality in critically ILL sepsis patients. Shock. 2018; 50(5):545-50. Doi:10.1097/SHK.0000000000001128.
Chen X, Zhou X, Zhao H, Wang Y, Pan H, Ma K, et al. Clinical value of the lactate/albumin ratio and lactate/albumin ratio × age score in the assessment of prognosis in patients with sepsis. Front Med. 2021;8:1-9. Doi:10.3389/fmed.2021.732410.
Yadav R, Yadav A. Lactate/Albumin ratio as prognostic tool for risk stratification in septic patients admitted to ICU. Crit Care Innov J. 2023; 11-22. doi:10.32114/CCI.2023.6.4.11.22.
Huang T, Lin S. Usefulness of lactate to albumin ratio for predicting in-hospital mortality in atrial fibrillation patients admitted to the Intensive Care Unit: A retrospective analysis from Mimic-IV database. BMC Anesthesiology. 2024;24(1):1-9. Doi:10.1186/s12871-024-02470-4.
Chebl RB, Geha M, Assaf M, Kattouf N, Haidar S, Abdeldaem K, et al. The prognostic value of the lactate/albumin ratio for predicting mortality in septic patients presenting to the Emergency Department: A prospective study. Ann Med. 2021; 53(1): 2268–277. Doi:10.1080/07853890.2021.2009125.
Sharma S, Khuman K, Sheth V, Parmar, R. Serial evaluation of SOFA score for predicting outcome in critically ill patients admitted in medical ICU’, Glob J Res Anal. 2024;13(4): 6–8. https://doi.org/10.36106/gjra/3600370.
Copyright (c) 2026 desti pasmawati
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The Contributor and the company/institution agree that all copies of the Final Published
Version or any part thereof distributed or posted by them in print or electronic format as permitted herein will include the notice of copyright as stipulated in the Journal and a full citation to the Journal.
