Elevated lactate/albumin ratio as a novel predictor of in-hospital mortality in hospitalized cirrhotics
Introduction and Objectives: Novel predictors of prognosis in cirrhotic patients have been emerging in recent years and studies show that the lactate/albumin ratio can serve as an early prognostic marker in different patient groups. We aimed to uncover the clinical significance of the lactate/albumi...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268123000017 |
| _version_ | 1827958080496730112 |
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| author | Itamar Krispin Mahmud Mahamid Eran Goldin Bashar Fteiha |
| author_facet | Itamar Krispin Mahmud Mahamid Eran Goldin Bashar Fteiha |
| author_sort | Itamar Krispin |
| collection | DOAJ |
| description | Introduction and Objectives: Novel predictors of prognosis in cirrhotic patients have been emerging in recent years and studies show that the lactate/albumin ratio can serve as an early prognostic marker in different patient groups. We aimed to uncover the clinical significance of the lactate/albumin ratio in hospitalized patients with acutely decompensated cirrhosis. Materials and Methods: A retrospective single-center cohort study was conducted in a tertiary medical center. Subjects included had an established diagnosis of liver cirrhosis and were admitted to the ICU or the Internal Medicine department with a clinical picture of acute-on-chronic liver failure between the years 2010 and 2021. The primary outcome was to assess the utility of the lactate/albumin ratio as a prognostic marker to predict mortality in hospitalized cirrhotic patients with acute-on-chronic hepatic failure. Results: Two hundred seventy-nine patients were included in this study. Univariate analysis revealed that mean WBC count, platelet/creatinine ratio, aspartate transaminase (AST), lactate, and MELD score were all significantly associated with the primary outcome. Multivariate analysis showed that the lactate/albumin ratio was the strongest statistically significant (p < 0.001) predictor of death during hospitalization - OR 13.196 (95% CI 3.6–48.3), followed by mean WBC count, MELD score, and serum lactate levels. A ROC curve was constructed, which resulted in an area under the curve (AUC) equal to 0.77. Crosstabs from the ROC showed a sensitivity of 66.7% and a specificity of 76.2% when the lactate/albumin ratio chosen as a cutoff was 0.9061 Conclusions: Elevated lactate/albumin ratio predicts in-hospital mortality in hospitalized cirrhotics with acute-on-chronic hepatic failure. |
| first_indexed | 2024-04-09T15:29:57Z |
| format | Article |
| id | doaj.art-408e340f1b374bb590305881bac27dff |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-09T15:29:57Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-408e340f1b374bb590305881bac27dff2023-04-28T08:55:09ZengElsevierAnnals of Hepatology1665-26812023-05-01283100897Elevated lactate/albumin ratio as a novel predictor of in-hospital mortality in hospitalized cirrhoticsItamar Krispin0Mahmud Mahamid1Eran Goldin2Bashar Fteiha3Department of Military Medicine and “Tzameret”, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Medical Corps, Israel Defense Forces, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Israel; Shaare Zedek Medical Center, the Digestive Diseases Institute, Jerusalem 9103102, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Israel; Shaare Zedek Medical Center, the Digestive Diseases Institute, Jerusalem 9103102, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Israel; Shaare Zedek Medical Center, the Digestive Diseases Institute, Jerusalem 9103102, Israel; Corresponding author.Introduction and Objectives: Novel predictors of prognosis in cirrhotic patients have been emerging in recent years and studies show that the lactate/albumin ratio can serve as an early prognostic marker in different patient groups. We aimed to uncover the clinical significance of the lactate/albumin ratio in hospitalized patients with acutely decompensated cirrhosis. Materials and Methods: A retrospective single-center cohort study was conducted in a tertiary medical center. Subjects included had an established diagnosis of liver cirrhosis and were admitted to the ICU or the Internal Medicine department with a clinical picture of acute-on-chronic liver failure between the years 2010 and 2021. The primary outcome was to assess the utility of the lactate/albumin ratio as a prognostic marker to predict mortality in hospitalized cirrhotic patients with acute-on-chronic hepatic failure. Results: Two hundred seventy-nine patients were included in this study. Univariate analysis revealed that mean WBC count, platelet/creatinine ratio, aspartate transaminase (AST), lactate, and MELD score were all significantly associated with the primary outcome. Multivariate analysis showed that the lactate/albumin ratio was the strongest statistically significant (p < 0.001) predictor of death during hospitalization - OR 13.196 (95% CI 3.6–48.3), followed by mean WBC count, MELD score, and serum lactate levels. A ROC curve was constructed, which resulted in an area under the curve (AUC) equal to 0.77. Crosstabs from the ROC showed a sensitivity of 66.7% and a specificity of 76.2% when the lactate/albumin ratio chosen as a cutoff was 0.9061 Conclusions: Elevated lactate/albumin ratio predicts in-hospital mortality in hospitalized cirrhotics with acute-on-chronic hepatic failure.http://www.sciencedirect.com/science/article/pii/S1665268123000017CirrhosisLiver failureMortalityHepatic decompensationIntensive care |
| spellingShingle | Itamar Krispin Mahmud Mahamid Eran Goldin Bashar Fteiha Elevated lactate/albumin ratio as a novel predictor of in-hospital mortality in hospitalized cirrhotics Annals of Hepatology Cirrhosis Liver failure Mortality Hepatic decompensation Intensive care |
| title | Elevated lactate/albumin ratio as a novel predictor of in-hospital mortality in hospitalized cirrhotics |
| title_full | Elevated lactate/albumin ratio as a novel predictor of in-hospital mortality in hospitalized cirrhotics |
| title_fullStr | Elevated lactate/albumin ratio as a novel predictor of in-hospital mortality in hospitalized cirrhotics |
| title_full_unstemmed | Elevated lactate/albumin ratio as a novel predictor of in-hospital mortality in hospitalized cirrhotics |
| title_short | Elevated lactate/albumin ratio as a novel predictor of in-hospital mortality in hospitalized cirrhotics |
| title_sort | elevated lactate albumin ratio as a novel predictor of in hospital mortality in hospitalized cirrhotics |
| topic | Cirrhosis Liver failure Mortality Hepatic decompensation Intensive care |
| url | http://www.sciencedirect.com/science/article/pii/S1665268123000017 |
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