The profile of lactate, albumin, and lactate/albumin ratio as predictors of mortality in sepsis patients

Abstract

Background. Oxygenation disturbances in sepsis patients may cause lactate levels increase which is proportional to the severity of the inflammation, followed by decrease in albumin levels. Combination of these two parameters is expected to be predictor of mortality in patients with sepsis. The aim of this study is to investigate the profile of lactate, albumin, and lactate/albumin ratio as mortality predictors in patient with sepsis. Methods. This prospective cohort study was conducted in the ICU of dr. Saiful Anwar Hospital, Malang, from January to May 2019. Subjects were 82 patients with sepsis (SOFA score > 2). Lactate and albumin levels were measured on the first day of hospitalization. Lactate levels were examined by colorimetric method, albumin was examined by BCG method. The instrument used was Cobas 501. Comparation was carried out using the T-Test/Mann–Whitney test. Prediction of mortality risk was done using relative risk (RR) determination. Results. Significant difference was observed in albumin levels between sepsis patients who survived and who died (p = 0.045). No significant differences were observed in lactate levels and lactate/albumin ratio between sepsis patients who survived and who died (p = 0.211, 0.119, respectively). Relative risks were 3.034 for lactate, 3.667 for albumin, and 4.400 for lactate/albumin ratio. Conclusion. In patients with sepsis, albumin level is the best variable in predicting mortality, followed by lactate/albumin ratio and lactate value. Further study that implements repeated measurement of lactate and albumin in 6 and 12 hours is required to better predict the mortality of sepsis patients.

Keywords

• lactate
• albumin
• lactate/albumin ratio
• mortality
• sepsis
• prognosis