Prognostic Value of the Lactate/Albumin Ratio in Sepsis-Related Mortality: An Exploratory Study in a Tertiary Care Center with Limited Resources in Western Mexico

乳酸/白蛋白比值在脓毒症相关死亡率中的预后价值:墨西哥西部一家资源有限的三级医疗中心的探索性研究

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Abstract

Background and Objectives: 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. Materials and Methods: 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. Results: 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, p = 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. Conclusions: 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.

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