title: Correlation of lactate/albumin ratio level to organ failure and mortality in severe sepsis and septic shock.
abstract: BACKGROUND
  This study examines the clinical utility of the increased lactate/albumin ratio as an indicator of multiple-organ dysfunction syndrome (MODS) and mortality in severe sepsis and septic shock.
  
  
  METHODS
  We designed a prospective cohort study in an intensive care unit, and 54 patients with severe sepsis or septic shock were included. Data were used to determine a relationship between lactate/albumin ratio and the development of MODS and mortality. These associations were determined by the Mann-Whitney test, multiple logistic regression, plotting the receiver operating characteristic curve and Spearman test.
  
  
  RESULTS
  Lactate/albumin ratio level was higher in MODS patients on day 1 (median [interquartile range, or IQR], 2.295 [1.818-3.065]; n = 30, P < .0001) than in those without (median [IQR], 1.550 (1.428-1.685); n = 24), and on day 2, (median [IQR], 1.810 [1.377-2.448]; n = 26, P = .0022) it was higher than in those without (median [IQR], 1.172 (1.129-1.382); n = 23) on day 2. We found that lactate/albumin ratio was an independent predictor of the development of MODS (odds ratio, 5.5; P = .033; 95% confidence interval, 1.1-26.1) during intensive care unit stay. The area under the receiver operating characteristic curve showed that lactate/albumin ratio could predict MODS (0.8458) and mortality (0.8449). Furthermore, the higher the Acute Physiology and Chronic Health Evaluation II score, the more lactate/albumin ratio was discovered on day 1 (r = 0.5315, P < .0001) and day 2 (r = 0.5408, P < .0001), whereas the lower partial pressure of oxygen in arterial blood/fraction of inspired oxygen ratio, the more lactate/albumin ratio was illustrated on day 1 (r = -0.5143, P < .0001) and day 2 (r = -0.5420, P < .0001).
  
  
  CONCLUSIONS
  Increased lactate/albumin ratio correlates with the development of MODS and mortality in patients with severe sepsis and septic shock.
authors.affiliation: Department of Critical Care Medicine, The Affiliated Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, PR China. Electronic address: biaowangsz@163.com.
authors.forename: Biao
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Critical Care Medicine, The Affiliated Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, PR China.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Critical Care Medicine, The Affiliated Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, PR China.
authors.forename: Yifei
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Critical Care Medicine, The Affiliated Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, PR China.
authors.forename: Jiping
authors.initials: J
authors.lastname: Xue
authors.affiliation: Department of Critical Care Medicine, The Affiliated Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, PR China.
authors.forename: Jia
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Critical Care Medicine, The Affiliated Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, PR China. Electronic address: icuwu@163.com.
authors.forename: Yunfu
authors.initials: Y
authors.lastname: Wu
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D019344:Lactic Acid / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood* / Q000401:mortality*; D015999:Multivariate Analysis; D011446:Prospective Studies; D012372:ROC Curve; D018805:Sepsis / Q000097:blood* / Q000401:mortality*; D012709:Serum Albumin / Q000032:analysis*; D012772:Shock, Septic / Q000097:blood / Q000401:mortality
chemical_list: D012709:Serum Albumin; D019344:Lactic Acid
keywords: Inflammation; Lactate/albumin ratio; MODS; Resuscitation; Severe sepsis and septic shock