Co-Evaluation of Lactate, Base Excess, and Albumin as Predictors of Mortality in Sepsis by Excluding the Factors That Affect Their Levels: An Observational Study

通过排除影响乳酸、碱剩余和白蛋白水平的因素,对这三者作为脓毒症死亡率预测指标进行联合评估:一项观察性研究

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Abstract

Purpose: Our aim was to determine the benefits of serum lactate, albumin, and base excess (BE) values in predicting prognosis and mortality in sepsis when evaluated together. Methods: We performed a prospective observational study. We included 217 patients who were 18 years old or older, admitted to the Adult Emergency Department at Hacettepe University Hospital between May 2019 and July 2020, and who had two or more SOFA scores. We evaluated admission hour, 24th hour and 48th hour lactate, albumin, and BE. Results: A decrease in 0, 24th, and 48th hour albumin values increases the mortality of sepsis patients. An increase in the 24th hour lactate value increases hospital mortality. Changes in BE values had no effect on hospital mortality. Hospital mortality increases as 24 h lactate clearance decreases. Alactic base excess has no effect on mortality. The AUC values of lactate and albumin are significant, but their sensitivities are low. The AUC value for 24 h lactate clearance is significant, but the sensitivity of the AUC value is low. Conclusions: Contrary to the literature, lactate, albumin, and BE were found to have low sensitivity in determining prognosis and mortality. When factors that may influence serum lactate, albumin, and base excess (BE) are excluded, the values of these biomarkers decrease when predicting mortality.

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