Shin et al reported the lactate to albumin ratio as a prognostic factor for a patient with sepsis. The authors are from multiple institutions in South Korea.
Patient selection: sepsis
Observed 28-day mortality rate: 22.5%
Risk factors for mortality:
(1) high lactate (>= 4.0 mmol/L)
(2) hypoalbuminemia (< 3.0 g/dL)
Risk factors for decreased lactate elimination:
(1) hepatic dysfunction
(2) renal dysfunction
Parameters:
(1) blood lactate in mmol/L
(2) serum albumin in g/dL
lactate to albumin ratio =
= (blood lactate) / (serum albumin)
Interpretation:
• The ratio for normal values of lactate and albumin < 0.49.
• The optimal cutoff for prediction of 28-day mortality was a ratio >= 1.32.
• Rapid clearance of blood lactate is associated with a better prognosis. A ratio that remains unchanged or that increases may indicate a poor prognosis.
Performance:
• The area under the ROC curve is 0.69.
