tetano
Editor, Senior Moderator
J Clin Med
. 2024 Nov 24;13(23):7106.
doi: 10.3390/jcm13237106. Lactate to Albumin Ratio and Mortality in Patients with Severe Coronavirus Disease-2019 Admitted to an Intensive Care Unit
Stelios Kokkoris[SUP] 1 [/SUP], Aikaterini Gkoufa[SUP] 1 [/SUP], Dimitrios E Katsaros[SUP] 1 [/SUP], Stavros Karageorgiou[SUP] 1 [/SUP], Fotios Kavallieratos[SUP] 1 [/SUP], Dimitrios Tsilivarakis[SUP] 1 [/SUP], Georgia Dimopoulou[SUP] 1 [/SUP], Evangelia Theodorou[SUP] 1 [/SUP], Eleftheria Mizi[SUP] 1 [/SUP], Anastasia Kotanidou[SUP] 1 [/SUP], Ioanna Dimopoulou[SUP] 1 [/SUP], Christina Routsi[SUP] 1 [/SUP]
Affiliations
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.
Keywords: COVID-19; SARS-CoV-2; albumin; intensive care unit; lactate; outcome; sepsis.
. 2024 Nov 24;13(23):7106.
doi: 10.3390/jcm13237106. Lactate to Albumin Ratio and Mortality in Patients with Severe Coronavirus Disease-2019 Admitted to an Intensive Care Unit
Stelios Kokkoris[SUP] 1 [/SUP], Aikaterini Gkoufa[SUP] 1 [/SUP], Dimitrios E Katsaros[SUP] 1 [/SUP], Stavros Karageorgiou[SUP] 1 [/SUP], Fotios Kavallieratos[SUP] 1 [/SUP], Dimitrios Tsilivarakis[SUP] 1 [/SUP], Georgia Dimopoulou[SUP] 1 [/SUP], Evangelia Theodorou[SUP] 1 [/SUP], Eleftheria Mizi[SUP] 1 [/SUP], Anastasia Kotanidou[SUP] 1 [/SUP], Ioanna Dimopoulou[SUP] 1 [/SUP], Christina Routsi[SUP] 1 [/SUP]
Affiliations
- PMID: 39685564
- PMCID: PMC11642242
- DOI: 10.3390/jcm13237106
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.
Keywords: COVID-19; SARS-CoV-2; albumin; intensive care unit; lactate; outcome; sepsis.