• Biao Wang, Gang Chen, Yifei Cao, Jiping Xue, Jia Li, and Yunfu Wu.
• Department of Critical Care Medicine, The Affiliated Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, PR China. Electronic address: biaowangsz@163.com.
• J Crit Care. 2015 Apr 1;30(2):271-5.

BackgroundThis 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.MethodsWe 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.ResultsLactate/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).ConclusionsIncreased lactate/albumin ratio correlates with the development of MODS and mortality in patients with severe sepsis and septic shock.Copyright © 2014 Elsevier Inc. All rights reserved.

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