Bae Sung Jin, Namgung Myeong, Jung Kwang Yul, Lee Dong Hoon, Choi Yoon Hee, Choi Yunhyung, Chung Ho Sub
Department of Emergency Medicine, Chung-Ang University Gwangmyeong Hospital, College of Medicine, Chung-Ang University, Seoul, 110, Deokan-Ro, Gwangmyeong-Si, Gyeonggi-Do, Republic of Korea.
Department of Emergency Medicine, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, 1071, Anyangcheon-Ro, Yangcheon-Gu, Seoul, Republic of Korea.
Intern Emerg Med. 2025 Apr;20(3):877-885. doi: 10.1007/s11739-024-03723-3. Epub 2024 Jul 26.
Gastrointestinal bleeding (GIB) is a common cause of emergency department (ED) visits, and has various prognoses. This study aimed to verify the prognostic ability of the lactate/albumin (L/A) ratio in patients with GIB compared with the AIMS65 score and blood urea nitrogen/albumin (B/A) ratio. This retrospective study included patients with GIB symptoms who visited the ED in 2019. Baseline characteristics and laboratory data were obtained to calculate the L/A and B/A ratios and AIMS65 score. Each score was evaluated as a predictor of intensive care unit (ICU) admission and in-hospital mortality by using the area under the receiver operating characteristic (AUROC) curve. The multivariate logistic regression analysis revealed that the L/A ratio significantly predicted ICU admission and in-hospital mortality. The AUROC curve for predicting ICU admission were 0.788, 0.695, and 0.586 for the L/A, B/A, and AIMS65 scores, respectively, while the AUROC curve for predicting in-hospital mortality were 0.807, 0.799, and 0.683 for the L/A, B/A, and AIMS65 scores, respectively. The L/A ratio, which consists of the serum lactate and albumin levels, showed superior performance relative to the B/A ratio and AIMS65 score in predicting the prognosis of patients with GIB.
胃肠道出血(GIB)是急诊科(ED)就诊的常见原因,且有多种预后情况。本研究旨在验证与AIMS65评分及血尿素氮/白蛋白(B/A)比值相比,乳酸/白蛋白(L/A)比值对GIB患者的预后预测能力。这项回顾性研究纳入了2019年因GIB症状前往急诊科就诊的患者。获取基线特征和实验室数据以计算L/A和B/A比值以及AIMS65评分。通过使用受试者工作特征(AUROC)曲线下面积,将每个评分作为重症监护病房(ICU)入住和院内死亡的预测指标进行评估。多因素逻辑回归分析显示,L/A比值显著预测了ICU入住和院内死亡。预测ICU入住的AUROC曲线,L/A、B/A和AIMS65评分分别为0.788、0.695和0.586,而预测院内死亡的AUROC曲线,L/A、B/A和AIMS65评分分别为0.807、0.799和0.683。由血清乳酸和白蛋白水平组成的L/A比值在预测GIB患者预后方面相对于B/A比值和AIMS65评分表现更优。