Ponce-Orozco Octavio, Vicente-Hernandez Berenice, Ramirez-Ochoa Sol, Zepeda-Gutiérrez Luis Asdrúval, Ambriz-Alarcón Mauricio Alfredo, Cervantes-Guevara Gabino, Gonzalez-Ojeda Alejandro, Fuentes-Orozco Clotilde, Hernandez-Mora Francisco Javier, Cervantes-Cardona Guillermo A, Vazquez-Beltran Janet Cristina, Cervantes-Pérez Enrique
Department of Internal Medicine, Hospital Civil de Guadalajara Fray Antonio Alcalde, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44280, Mexico.
Subdirección Médica, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara 44280, Mexico.
J Clin Med. 2025 Apr 19;14(8):2825. doi: 10.3390/jcm14082825.
: Sepsis is a critical condition with high mortality rates worldwide. The early identification of patients at an elevated risk of mortality remains a significant clinical challenge. The lactate/albumin (L/A) ratio has emerged as a potential prognostic biomarker in critically ill patients. This exploratory study aimed to evaluate the L/A ratio as a predictor of mortality in patients with sepsis or septic shock and to describe the demographic and clinical characteristics of affected patients in a tertiary referral hospital in Western Mexico. : A retrospective cross-sectional study was conducted including patients diagnosed with sepsis or septic shock between January 2022 and June 2023. Clinical and biochemical data, including serum lactate and albumin levels, were collected from medical records to calculate the L/A ratio. The primary outcome was in-hospital mortality. The statistical analysis included receiver operating characteristic (ROC) curves to evaluate the L/A ratio's discriminative capacity, a bivariate analysis, and a multivariate logistic regression to identify independent risk factors for mortality. : A total of 141 patients were included in the study, and the median L/A ratio was significantly higher in non-survivors compared to survivors (0.95 vs. 0.60, = 0.003). The ROC analysis showed an area under the curve (AUC) of 0.651, with a sensitivity of 36.5% and specificity of 82% at a cutoff value of 1.12. The multivariate analysis identified serum albumin levels and vasopressor use as independent predictors of mortality. : The L/A ratio demonstrates potential as a simple and accessible prognostic biomarker for mortality in sepsis, though its utility requires further validation in larger prospective studies.
脓毒症是一种在全球范围内死亡率很高的危急病症。早期识别死亡风险升高的患者仍然是一项重大的临床挑战。乳酸/白蛋白(L/A)比值已成为危重症患者潜在的预后生物标志物。这项探索性研究旨在评估L/A比值作为脓毒症或脓毒性休克患者死亡率的预测指标,并描述墨西哥西部一家三级转诊医院中受影响患者的人口统计学和临床特征。
开展了一项回顾性横断面研究,纳入了2022年1月至2023年6月期间诊断为脓毒症或脓毒性休克的患者。从病历中收集临床和生化数据,包括血清乳酸和白蛋白水平,以计算L/A比值。主要结局是住院死亡率。统计分析包括用于评估L/A比值辨别能力的受试者工作特征(ROC)曲线、双变量分析以及用于识别死亡独立危险因素的多变量逻辑回归分析。
该研究共纳入141例患者,非幸存者的L/A比值中位数显著高于幸存者(0.95对0.60,P = 0.003)。ROC分析显示曲线下面积(AUC)为0.651,在临界值为1.12时,灵敏度为36.5%,特异性为82%。多变量分析确定血清白蛋白水平和血管升压药的使用是死亡的独立预测因素。虽然L/A比值作为脓毒症死亡率的一种简单且可获取的预后生物标志物显示出潜力,但其效用需要在更大规模的前瞻性研究中进一步验证。