Lee Bong-Kyu, Ryu Seung, Oh Se-Kwang, Ahn Hong-Joon, Jeon So-Young, Jeong Won-Joon, Cho Yong-Chul, Park Jung-Soo, You Yeon-Ho, Kang Chang-Shin
Department of Emergency Medicine, Chungnam National University Hospital, Jung-Gu, Daejeon, Republic of Korea.
Department of Emergency Medicine, Chungnam National University Hospital, Jung-Gu, Daejeon, Republic of Korea.
Am J Emerg Med. 2022 Feb;52:54-58. doi: 10.1016/j.ajem.2021.11.028. Epub 2021 Nov 25.
To verify the role of lactate dehydrogenase to albumin (LDH/ALB) ratio as an independent prognostic factor for mortality due to the lower respiratory tract infection (LRTI) in the emergency department (ED).
We reviewed the electronic medical records of patients who were admitted to the ED for the management of LRTI between January 2018 and December 2020. Initial vital signs, laboratory data, and patient severity scores in the ED were collected. The LDH/ALB ratio was compared to other albumin-based ratios (blood urea nitrogen to albumin ratio, C-reactive protein to albumin ratio, and lactate to albumin ratio) and severity scales (pneumonia severity index, modified early warning score, CURB-65 scores), which are being used as prognostic factors for in-hospital mortality. Multivariable logistic regression was performed to identify independent risk factors.
The LDH/ALB ratio was higher in the non-survivor group than in the survivor group (median [interquartile range]: 217.6 [160.3;312.0] vs. 126.4 [100.3;165.1], p < 0.001). In the comparison of the area under the receiver operating characteristic curve (AUC) for predicting in-hospital mortality, the AUC of the LDH/ALB ratio (0.808, 95% confidence interval: 0.757-0.842, p < 0.001) was wider than other albumin-based ratios and severity scales, except the blood urea nitrogen to albumin ratio. In the multivariable logistic regression analysis, the LDH/ALB ratio independently affected in-hospital mortality.
The LDH/ALB ratio may serve as an independent prognostic factor for in-hospital mortality in patients with LRTI.
验证乳酸脱氢酶与白蛋白比值（LDH/ALB）作为急诊科（ED）下呼吸道感染（LRTI）所致死亡的独立预后因素的作用。
我们回顾了2018年1月至2020年12月期间因LRTI到ED就诊并接受治疗的患者的电子病历。收集了患者在ED时的初始生命体征、实验室数据和病情严重程度评分。将LDH/ALB比值与其他基于白蛋白的比值（血尿素氮与白蛋白比值、C反应蛋白与白蛋白比值、乳酸与白蛋白比值）以及作为院内死亡预后因素的病情严重程度量表（肺炎严重程度指数、改良早期预警评分、CURB-65评分）进行比较。进行多变量逻辑回归以确定独立危险因素。
非存活组的LDH/ALB比值高于存活组（中位数[四分位间距]：217.6[160.3；312.0]对126.4[100.3；165.1]，p<0.001）。在预测院内死亡的受试者工作特征曲线（AUC）下面积比较中，LDH/ALB比值的AUC（0.808，95%置信区间：0.757-0.842，p<0.001）比其他基于白蛋白的比值和病情严重程度量表更宽，但血尿素氮与白蛋白比值除外。在多变量逻辑回归分析中，LDH/ALB比值独立影响院内死亡率。
LDH/ALB比值可能是LRTI患者院内死亡的独立预后因素。
