Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier St Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France; University Paris Diderot, Paris, France; FHU PROMICE, Paris, France.
Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier St Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France.
Burns. 2022 Dec;48(8):1836-1844. doi: 10.1016/j.burns.2022.01.003. Epub 2022 Jan 5.
Lactate albumin ratio (LAR) has been used as a prognostic marker associated with organ failure in critically ill septic patients. LAR and its association with outcomes has never been studied in burned patients. The aim of this study was to evaluate the ability of LAR to predict 28-day mortality.
A retrospective cohort study including all burn patients hospitalized in intensive care unit. The primary endpoint was the 28-day mortality.
One thousand three hundred thirty four patients were screened, and 471 were included between June 2012 and December 2018. Briefly, the population study was mainly composed by men (249, 59.1%), the median age, TBSA burned, full thickness, ABSI and IGS2 were 52 [34-68], 20 [10-40], 8 [1-23], 7 [5-9] and 25 [15-40] respectively. Fifty-two patients (12.4%) died at day 28 after admission. At admission, the LAR level was lower in 28-day survivors compared non-survivors (0.05 [0.04, 0.08] vs 0.12 [0.07, 0.26], p < 0.001 respectively). In multivariate analysis accounting for ABSI, LAR levels at admission> 0.13 was independently associated with 28-day mortality (adjusted OR = 3.98 (IC95 1.88-8.35)). The ability of LAR at admission to discriminate 28-day mortality showed an AUC identical when compared to SOFA and ABSI scores (0.81 (IC95 0.74-0.88), 0.80 (IC95 0.72-0.85) and (0.85 (IC95 0.80-0.90), p < 0.05, respectively). Patients with LAR levels ≥ 0.13 at admission had higher 28-day mortality (40.6% vs 6.8%, p < 0.001, HR 7.39 (IC95 4.28-12.76)).
At admission, LAR is an easy and reliable marker independently associated to 28-day mortality in patients with severe burn injury, but prediction by LAR does not perform better than lactate level alone.
乳酸白蛋白比值（LAR）已被用作与危重症脓毒症患者器官衰竭相关的预后标志物。LAR 及其与结局的关系从未在烧伤患者中进行过研究。本研究旨在评估 LAR 预测 28 天死亡率的能力。
这是一项回顾性队列研究，纳入了所有 ICU 住院的烧伤患者。主要终点是 28 天死亡率。
共筛选了 1334 名患者，其中 2012 年 6 月至 2018 年 12 月纳入 471 名患者。简要介绍一下，该人群研究主要由男性（249 名，59.1%）组成，中位年龄、TBSA 烧伤面积、全层烧伤、ABS 和 IGS2 分别为 52 [34-68]、20 [10-40]、8 [1-23]、7 [5-9]和 25 [15-40]。52 名（12.4%）患者在入院后 28 天死亡。入院时，28 天幸存者的 LAR 水平低于非幸存者（0.05 [0.04，0.08] vs 0.12 [0.07，0.26]，p < 0.001）。多变量分析考虑到 ABSI 后，入院时 LAR 水平>0.13 与 28 天死亡率独立相关（调整后的 OR=3.98（95%CI 1.88-8.35））。入院时 LAR 区分 28 天死亡率的能力与 SOFA 和 ABSI 评分相同（0.81（95%CI 0.74-0.88）、0.80（95%CI 0.72-0.85）和 0.85（95%CI 0.80-0.90），p < 0.05）。入院时 LAR 水平≥0.13 的患者 28 天死亡率更高（40.6% vs 6.8%，p < 0.001，HR 7.39（95%CI 4.28-12.76））。
入院时，LAR 是一种简单可靠的标志物，与严重烧伤患者 28 天死亡率独立相关，但 LAR 预测的效果并不优于单独的乳酸水平。
