Lactate to Albumin Ratio and Mortality in Patients with Severe Coronavirus Disease-2019 Admitted to an Intensive Care Unit.

Lactate to Albumin Ratio and Mortality in Patients with Severe Coronavirus Disease-2019 Admitted to an Intensive Care Unit.

Publication date: Nov 24, 2024

Aim: This study sought to evaluate the effectiveness of lactate/albumin ratio for ICU mortality prediction in a large cohort of patients with severe Coronavirus Disease-2019 (COVID-19) admitted to an intensive care unit (ICU). Methods: This is a single-center retrospective cohort study of prospectively collected data derived from the COVID-19 dataset for all critically ill patients admitted to an academic ICU. Data were used to determine the relation between lactate/albumin ratio and other laboratory parameters measured on the first day of the ICU stay and to evaluate the prognostic performance for ICU mortality prediction. Results: A total of 805 ICU patients were included, and the median age (IQR) was 67 (57-76) years, with 68% being male. ICU mortality was 48%, and the median lactate/albumin ratio was 0. 53 (0. 39-0. 59). A survival analysis showed that patients with higher lactate/albumin ratio values had significantly lower survival rates (Log Rank p < 0. 001). A multivariable analysis revealed that the lactate/albumin ratio was an independent risk factor for ICU mortality with a hazard ratio of 1. 39 (CI: 1. 27-1. 52). The lactate/albumin ratio showed a receiver operating characteristics area under the curve (ROC-AUC) value to predict ICU mortality significantly higher than that of lactate alone (0. 71 vs. 0. 68, DeLong test p < 0. 001). The optimal lactate/albumin ratio cut-off for predicting ICU mortality was 0. 57, with 63% sensitivity and 73% specificity. A subgroup analysis revealed that the lactate/albumin ratio was significantly associated with mortality across different patient groups, including age and sex categories, and those with or without hypertension and coronary heart disease. Conclusions: Lactate/albumin ratio is a reliable prognostic marker in critically ill COVID-19 patients and could predict ICU mortality more accurately than lactate alone.

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Concepts Keywords
Coronavirus albumin
Hypertension COVID-19
Mortality intensive care unit
Reliable lactate
outcome
SARS-CoV-2
sepsis

Semantics

Type Source Name
pathway KEGG Coronavirus disease
disease MESH COVID-19
disease MESH critically ill
drug DRUGBANK Saquinavir
disease MESH hypertension
disease MESH coronary heart disease
drug DRUGBANK Coenzyme M
disease MESH Infectious Diseases
disease MESH sepsis
drug DRUGBANK Oxygen
drug DRUGBANK Glycine
disease IDO production
disease IDO blood
disease MESH hyperlactatemia
disease MESH acidosis
disease MESH hypoxia
disease MESH circulatory failure
pathway REACTOME Glycolysis
disease MESH septic shock
disease MESH hypoalbuminemia
disease MESH malnutrition
drug DRUGBANK Nitrogen
drug DRUGBANK Isoxaflutole
drug DRUGBANK Human Serum Albumin
disease MESH inflammation
disease MESH emergency
disease IDO assay
drug DRUGBANK Dexamethasone
drug DRUGBANK Creatinine
drug DRUGBANK Dextrose unspecified form
drug DRUGBANK Fibrinogen Human
disease MESH diabetes mellitus
disease MESH obesity
disease MESH cardiovascular disease
disease MESH pulmonary disease
disease MESH chronic kidney disease
disease MESH malignancy
disease MESH Comorbidity
disease MESH hypotension
disease MESH tic

Original Article

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