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Int. J. Mol. Sci. 2017, 18(9), 1893;

The Lactate/Albumin Ratio: A Valuable Tool for Risk Stratification in Septic Patients Admitted to ICU

Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria
Clinic of Internal Medicine I, Department of Cardiology, Jena University Hospital, 07747 Jena, Germany
Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstraße 5, 40225 Dusseldorf, Germany
Department of Cardiology, Charité—Universitaetsmedizin Berlin, 12203 Berlin, Germany
Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Berlin, 13347 Berlin, Germany
Author to whom correspondence should be addressed.
Received: 28 July 2017 / Revised: 22 August 2017 / Accepted: 27 August 2017 / Published: 2 September 2017
(This article belongs to the Special Issue Sepsis)
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The lactate/albumin ratio has been reported to be associated with mortality in pediatric patients with sepsis. We aimed to evaluate the lactate/albumin ratio for its prognostic relevance in a larger collective of critically ill (adult) patients admitted to an intensive care unit (ICU). A total of 348 medical patients admitted to a German ICU for sepsis between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. The association of the lactate/albumin ratio (cut-off 0.15) and both in-hospital and post-discharge mortality was investigated. An optimal cut-off was calculated by means of Youden’s index. The lactate/albumin ratio was elevated in non-survivors (p < 0.001). Patients with an increased lactate/albumin ratio were of similar age, but clinically in a poorer condition and had more pronounced laboratory signs of multi-organ failure. An increased lactate/albumin ratio was associated with adverse in-hospital mortality. An optimal cut-off of 0.15 was calculated and was associated with adverse long-term outcome even after correction for APACHE2 and SAPS2. We matched 99 patients with a lactate/albumin ratio >0.15 to case-controls with a lactate/albumin ratio <0.15 corrected for APACHE2 scores: The group with a lactate/albumin ratio >0.15 evidenced adverse in-hospital outcome in a paired analysis with a difference of 27% (95%CI 10–43%; p < 0.01). Regarding long-term mortality, again, patients in the group with a lactate/albumin ratio >0.15 showed adverse outcomes (p < 0.001). An increased lactate/albumin ratio was significantly associated with an adverse outcome in critically ill patients admitted to an ICU, even after correction for confounders. The lactate/albumin ratio might constitute an independent, readily available, and important parameter for risk stratification in the critically ill. View Full-Text
Keywords: critically ill patients; lactate; albumin; lactate/albumin ratio; ICU; risk stratification; risk score critically ill patients; lactate; albumin; lactate/albumin ratio; ICU; risk stratification; risk score

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Lichtenauer, M.; Wernly, B.; Ohnewein, B.; Franz, M.; Kabisch, B.; Muessig, J.; Masyuk, M.; Lauten, A.; Schulze, P.C.; Hoppe, U.C.; Kelm, M.; Jung, C. The Lactate/Albumin Ratio: A Valuable Tool for Risk Stratification in Septic Patients Admitted to ICU. Int. J. Mol. Sci. 2017, 18, 1893.

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