Association between the lactate/albumin ratio and mortality in pediatric septic shock patients with underlying chronic disease: retrospective pilot study

Abstract

BACKGROUND: We aimed to evaluate the ability of the lactate/albumin ratio to predict mortality in pediatric septic shock patients.

METHODS: Retrospective analysis of the medical records of a pediatric intensive care unit. The study cohort comprised 90 pediatric septic shock patients admitted from February 2012 to May 2015.

RESULTS: The serum lactate and albumin levels and lactate/albumin ratio were compared between survivors and nonsurvivors. We assessed whether the lactate/albumin ratio could be used to predict mortality. The 28-day hospital mortality was 26.7% (24/90). The lactate level was higher (2.5 +/- 2.2 vs. 8.1 +/- 5.1 mmol/L, P<0.001) and the albumin level was lower (2.9 +/- 0.5 vs. 2.7 +/- 0.5 mg/dL, P=0.063) in non-survivors than in survivors. The lactate/albumin ratio was 0.9 +/- 0.8 in survivors and 3.2 +/- 2.4 in non-survivors (P<0.001). According to the area under the receiver operating characteristic curve (AUC), the lactate/albumin ratio showed good discriminatory power for predicting mortality (AUC=0.867). A lactate/ albumin ratio exceeding 1.016 led to a 7.636-fold increase in mortality.

CONCLUSIONS: The lactate/albumin ratio is a useful predictor of mortality in pediatric septic shock patients.