(1500) Lactic Acid-to-Albumin Ratio: Prognostic Marker of Sepsis

Introduction: Various scoring systems are employed in clinical settings to assess morbidity and mortality rates among septic patients, including the Acute Physiologic and Chronic Health Evaluation (APACHE), quick Sequential Organ Failure Assessment (qSOFA), and Sequential (sepsis-related) Organ Failure Assessment (SOFA) scoring systems. However, these systems involve multiple clinical variables, which can complicate their use in practical clinical scenarios. Given the significance of lactic acid and albumin levels in indicating the severity of sepsis, we aimed to investigate whether the lactic acid to albumin ratio (LAR) could serve as a straightforward tool for predicting multi organ dysfunction syndrome (MODS) and mortality in septic patients.

Methods: We conducted a retrospective observational analysis of patient charts at a rural community-based hospital spanning from 2017 to 2023 to assess whether LAR independently predicts MODS and mortality among ICU-admitted sepsis patients. Our study encompassed all adult patients (aged 18 years and above) diagnosed with sepsis (ICD-10- CM code A41.9) who were admitted to the ICU. Demographic data, comorbidities, and laboratory findings at admission were collected. Logistic regression analysis was performed to evaluate the association between hospital mortality and LAR, adjusting for age, gender, and race. LAR values were categorized into three groups: (a) Less than 1, (b) between 1 to 3, and (c) greater than 3.

Results: A total of 3526 septic patients were admitted to the ICU between 2017 and 2023, with a mean age of 62.8 years (SD 15.6 years). In-hospital mortality varied significantly (p < 0.001) across the three LAR groups: 5.4% (LAR < 1), 10.8% (LAR 1-3), and 28.9% (LAR > 3). Adjusted analysis revealed that the odds of mortality were 2.1 times higher (95% CI 1.5-2.8) in the LAR 1-3 group and 7.5 times higher (95% CI 4.5-12.6) in the LAR > 3 group compared to those with LAR < 1. The area under the receiver operating characteristic curve (ROC) was 0.68.

Conclusions: The LAR was associated with in hospital mortality in septic patient which increased significantly with LAR > 3. The LAR represents a simple yet valuable and expedient tool for prognosticating septic patients in ICU.