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Scand. J. Clin. Lab. Invest. · Oct 2016
The combined use of three widely available biochemical markers as predictor of organ failure in critically ill patients.
- Fredrik Helliksson, Jan Wernerman, Lars Wiklund, Jon Rosell, and Mathias Karlsson.
- a Department of Clinical Science , Intervention, and Technology, CLINTEC, Karolinska Institutet , Stockholm , Sweden ;
- Scand. J. Clin. Lab. Invest. 2016 Oct 1; 76 (6): 479-85.
BackgroundWe hypothesized that lactate dehydrogenase, LDH/albumin ratio in combination with or without magnesium (Mg(2+)) could predict organ failure in critically ill adult patients. The aim of this study was to describe a new risk index for organ failure or mortality in critically ill patients based on a combination of these routinely available biochemical plasma biomarkers.MethodsPatients ≥ 18 years admitted to the intensive care unit (ICU) were screened. Albumin and LDH were analyzed at the time of admission to ICU (n = 347). Organ failure assessed with 'Sequential Organ Failure Assessment' (SOFA) score was used, and 30-day mortality was recorded. The predictive value of the test was calculated using the areas under the receiving operating characteristic (ROC) curve.ResultsThe LDH/albumin ratio was higher in patients who developed organ failure as compared to those who did not (p < 0.001). The areas under the ROC curve were 0.77 both for prediction of multiple organ failure and for 30-day mortality. In a subgroup of patients (n = 183) admitted to ICU from the emergency department, the predictive values were 0.86 and 0.80, respectively.ConclusionThe LDH/albumin ratio at ICU admission was associated with the development of multiple organ failure and 30-day mortality in this prospective study. The clinical value of this biomarker as a predictor of organ failure in critically ill patients is yet to be defined.
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