Helliksson Fredrik, Wernerman Jan, Wiklund Lars, Rosell Jon, Karlsson Mathias
a Department of Clinical Science , Intervention, and Technology, CLINTEC, Karolinska Institutet , Stockholm , Sweden ;
b Department of Anesthesiology and Intensive Care , Central Hospital , Karlstad , Sweden ;
Scand J Clin Lab Invest. 2016 Oct;76(6):479-85. doi: 10.1080/00365513.2016.1201850. Epub 2016 Jun 30.
We hypothesized that lactate dehydrogenase, LDH/albumin ratio in combination with or without magnesium (Mg(2+)) could predict organ failure in critically ill adult patients. The aim of this study was to describe a new risk index for organ failure or mortality in critically ill patients based on a combination of these routinely available biochemical plasma biomarkers.
Patients ≥ 18 years admitted to the intensive care unit (ICU) were screened. Albumin and LDH were analyzed at the time of admission to ICU (n = 347). Organ failure assessed with 'Sequential Organ Failure Assessment' (SOFA) score was used, and 30-day mortality was recorded. The predictive value of the test was calculated using the areas under the receiving operating characteristic (ROC) curve.
The LDH/albumin ratio was higher in patients who developed organ failure as compared to those who did not (p < 0.001). The areas under the ROC curve were 0.77 both for prediction of multiple organ failure and for 30-day mortality. In a subgroup of patients (n = 183) admitted to ICU from the emergency department, the predictive values were 0.86 and 0.80, respectively.
The LDH/albumin ratio at ICU admission was associated with the development of multiple organ failure and 30-day mortality in this prospective study. The clinical value of this biomarker as a predictor of organ failure in critically ill patients is yet to be defined.
我们假设乳酸脱氢酶、乳酸脱氢酶/白蛋白比值联合或不联合镁离子（Mg(2+)）可预测危重症成年患者的器官衰竭。本研究的目的是基于这些常规可得的血浆生化生物标志物组合，描述一种用于危重症患者器官衰竭或死亡的新风险指数。
筛选入住重症监护病房（ICU）且年龄≥18岁的患者。在入住ICU时分析白蛋白和乳酸脱氢酶（n = 347）。采用“序贯器官衰竭评估”（SOFA）评分评估器官衰竭，并记录30天死亡率。使用受试者操作特征（ROC）曲线下面积计算该检测的预测价值。
发生器官衰竭的患者的乳酸脱氢酶/白蛋白比值高于未发生器官衰竭的患者（p < 0.001）。预测多器官衰竭和30天死亡率的ROC曲线下面积均为0.77。在从急诊科入住ICU的患者亚组（n = 183）中，预测值分别为0.86和0.80。
在这项前瞻性研究中，入住ICU时的乳酸脱氢酶/白蛋白比值与多器官衰竭的发生及30天死亡率相关。这种生物标志物作为危重症患者器官衰竭预测指标的临床价值尚待确定。
