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乳酸/白蛋白比值在预测重症监护脓毒症患者临床结局方面比单独的乳酸或白蛋白更有效。

Lactate/albumin ratio is more effective than lactate or albumin alone in predicting clinical outcomes in intensive care patients with sepsis.

机构信息

Department of Anesthesiology and Clinical of Critical Care, Health Sciences University, Ankara Numune Education and Research Hospital, Ankara, Turkey.

出版信息

Scand J Clin Lab Invest. 2021 May;81(3):225-229. doi: 10.1080/00365513.2021.1901306. Epub 2021 Mar 20.

Abstract

This study aimed to compare the value of lactate, albumin, and lactate/albumin ratio for the prediction of mortality in sepsis patients. Patients admitted to the intensive care unit (ICU) due to sepsis between January 2016 and January 2019 were evaluated retrospectively. Lactate, albumin, and lactate/albumin ratio values were compared between surviving and non-surviving patients and their predictive value for mortality was evaluated. A total of 1136 sepsis patients admitted to the ICU were included in the study. The mortality rate was 42.7% (485/1136 patients). In ROC analysis for mortality prediction, the area under the curve and optimal cut-off values were 0.816 and >2.2 mmol/L for lactate, 0.812 and ≤26 g/L for albumin, and 0.869 and >0.71 for lactate/albumin ratio, respectively. Our analysis of lactate, albumin, and lactate/albumin ratio in the largest patient sample to date showed that lactate/albumin ratio was a stronger parameter than lactate or albumin alone in predicting mortality among sepsis patients in the ICU. Lactate/albumin ratio is an easily obtained parameter with potential value for critically ill patients.

摘要

本研究旨在比较乳酸、白蛋白和乳酸/白蛋白比值在预测脓毒症患者死亡率方面的价值。回顾性评估了 2016 年 1 月至 2019 年 1 月期间因脓毒症入住重症监护病房(ICU)的患者。比较了存活患者和非存活患者的乳酸、白蛋白和乳酸/白蛋白比值,并评估了它们对死亡率的预测价值。共纳入 1136 例入住 ICU 的脓毒症患者。死亡率为 42.7%(485/1136 例)。在用于死亡率预测的 ROC 分析中,乳酸的曲线下面积和最佳截断值分别为 0.816 和 >2.2mmol/L,白蛋白为 0.812 和 ≤26g/L,乳酸/白蛋白比值为 0.869 和 >0.71。我们对迄今为止最大的患者样本中的乳酸、白蛋白和乳酸/白蛋白比值进行的分析表明,在 ICU 中预测脓毒症患者死亡率时,乳酸/白蛋白比值比乳酸或白蛋白单独作为参数更为有效。乳酸/白蛋白比值是一个易于获得的参数,对危重症患者具有潜在价值。

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