Hancı Pervin, Temel Esra, Bilir Furkan, Kaya Bilkay Serez
Department of Pulmonary Medicine and Division of Intensive Care, Trakya University Faculty of Medicine, Trakya University Medical Research and Application Centre, Edirne, TR-22030, Turkey.
Department of Pulmonology, Trakya University Faculty of Medicine, Edirne, Türkiye.
BMC Pulm Med. 2025 May 9;25(1):224. doi: 10.1186/s12890-025-03698-7.
Previous studies have shown that the lactate/albumin ratio (LAR) can be a prognostic biomarker in intensive care unit (ICU) patients. However, the usefulness of LAR in predicting mortality and guiding intensive care unit admission in hospitalized patients due to community-acquired pneumonia (CAP) remains unclear. This study aims to evaluate the predictive value of the LAR compared to Pneumonia Severity Index (PSI), Confusion, urea, respiratory rate, blood pressure, 65 years or older (CURB-65), and quick-Sequential Organ Failure Assessment (q-SOFA) scores in determining the need for ICU admission and mortality among hospitalized patients with CAP.
Adult patients diagnosed and hospitalized with community-acquired pneumonia between July 2021 and July 2023 were included. Patients' demographics, comorbidities, disease severity scores, laboratory findings at the admission and outcomes were recorded. Patients were grouped and compared according to admission place (ward or ICU).
PSI, CURB-65, q-SOFA scores, and LAR were higher in ICU patients than in those admitted to the ward. Regarding the ICU admission, the AUC values for PSI, CURB-65, q-SOFA and LAR were 0.794 (95% CI: 0.737-0.843) (p < 0.001), 0.825 (95% CI: 0.771-0.870) (p < 0.001), 0.755 (0.690-0.813) (p < 0.001), and 0.749 (95% CI: 0.689-0.802) (p < 0.001), respectively. Regarding the mortality, the AUC values for PSI, CURB-65, q-SOFA, and LAR were 0.722 (95% CI: 0.661-0.778) (p < 0.001), 0.743 (95% CI: 0.683-0.797) (p < 0.001), 0.645 (0.575-0.711) (p: 0.02), 0.761 (95% CI: 0.702-0.814) (p < 0.001), respectively. There wasn't any difference detected in pairwise comparisons of ROC curves.
In this study, LAR was found to be a good predictor of ICU admissions and mortality in hospitalized patients with CAP and was non-inferior to PSI, CURB-65, or q-SOFA scores.
既往研究表明，乳酸/白蛋白比值（LAR）可作为重症监护病房（ICU）患者的预后生物标志物。然而，LAR在预测社区获得性肺炎（CAP）住院患者的死亡率及指导ICU收治方面的作用仍不明确。本研究旨在评估LAR与肺炎严重程度指数（PSI）、意识障碍、尿素、呼吸频率、血压、年龄≥65岁（CURB-65）及快速序贯器官衰竭评估（q-SOFA）评分相比，在确定CAP住院患者ICU收治需求及死亡率方面的预测价值。
纳入2021年7月至2023年7月间诊断并住院的成年社区获得性肺炎患者。记录患者的人口统计学资料、合并症、疾病严重程度评分、入院时的实验室检查结果及结局。根据收治地点（病房或ICU）对患者进行分组并比较。
ICU患者的PSI、CURB-65、q-SOFA评分及LAR高于病房收治患者。关于ICU收治，PSI、CURB-65、q-SOFA及LAR的AUC值分别为0.794（95%CI：0.737 - 0.843）（p < 0.001）、0.825（95%CI：0.771 - 0.870）（p < 0.001）、0.755（0.690 - 0.813）（p < 0.001）及0.749（95%CI：0.689 - 0.802）（p < 0.001）。关于死亡率，PSI、CURB-65、q-SOFA及LAR 的AUC值分别为0.722（95%CI：0.661 - 0.778）（p < 0.001）、0.743（95%CI：0.683 - 0.797）（p < 0.001）、0.645（0.575 - 0.711）（p = 0.02）、0.761（95%CI：0.702 - 0.814）（p < 0.001）。ROC曲线的两两比较未发现差异。
在本研究中，发现LAR是CAP住院患者ICU收治及死亡率的良好预测指标，且不劣于PSI、CURB-65或q-SOFA评分。
