The predictive value of the lactate/albumin ratio combined with APACHE II and injury severity score for short-term prognosis in patients with polytrauma

乳酸/白蛋白比值联合APACHE II评分和损伤严重程度评分对多发性创伤患者短期预后的预测价值

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Abstract

BACKGROUND: Polytrauma is the simultaneous or sequential occurrence of injuries. Current prognostic indicators of this condition have limitations. This study aimed to investigate the correlation between lactate/albumin ratio (LAR) and short-term prognosis in polytrauma patients and evaluate the predictive value of combining LAR with the Acute Physiology and Chronic Health Evaluation II (APACHE II) and Injury Severity Score (ISS). METHODS: Clinical data from 113 polytrauma patients admitted to the intensive care unit of the Second People's Hospital of Hefei(February 2019-July 2024) were analyzed. Receiver operating characteristic (ROC) curves were used to assess the predictive performance of the LAR, APACHE II, ISS, and their combinations. Logistic regression identified risk factors for poor prognosis. RESULTS: ROC analysis showed strong predictive value for poor short-term prognosis by APACHE II (area under the curve [AUC] = 0.931), ISS (AUC = 0.812), and LAR at 48 h (AUC = 0.901; all P < 0.05). The combination of APACHE II, ISS, and LAR at 48 h demonstrated superior predictive value (AUC = 0.968, P < 0.01). Logistic regression confirmed that APACHE II, ISS, and LAR at 48 h were independent risk factors for poor prognosis (all P < 0.05). CONCLUSION: LAR is correlated with short-term prognosis in patients with polytrauma. APACHE II, ISS, and LAR at 48 h are independent risk factors with strong individual predictive values, and their combination provides greater predictive power.

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