The lactate/albumin ratio has been reported to be associated with mortality in
pediatric patients with sepsis. We aimed to evaluate the lactate/albumin ratio
for its prognostic relevance in a larger collective of critically ill (adult)
patients admitted to an intensive care unit (ICU). A total of 348 medical
patients admitted to a German ICU for sepsis between 2004 and 2009 were
included. Follow-up of patients was performed retrospectively between May 2013
and November 2013. The association of the lactate/albumin ratio (cut-off 0.15)
and both in-hospital and post-discharge mortality was investigated. An optimal
cut-off was calculated by means of Youden’s index. The lactate/albumin ratio
was elevated in non-survivors (p < 0.001). Patients with an increased
lactate/albumin ratio were of similar age, but clinically in a poorer
condition and had more pronounced laboratory signs of multi-organ failure. An
increased lactate/albumin ratio was associated with adverse in-hospital
mortality. An optimal cut-off of 0.15 was calculated and was associated with
adverse long-term outcome even after correction for APACHE2 and SAPS2. We
matched 99 patients with a lactate/albumin ratio >0.15 to case-controls with a
lactate/albumin ratio <0.15 corrected for APACHE2 scores: The group with a
lactate/albumin ratio >0.15 evidenced adverse in-hospital outcome in a paired
analysis with a difference of 27% (95%CI 10–43%; p < 0.01). Regarding long-
term mortality, again, patients in the group with a lactate/albumin ratio
>0.15 showed adverse outcomes (p < 0.001). An increased lactate/albumin ratio
was significantly associated with an adverse outcome in critically ill
patients admitted to an ICU, even after correction for confounders. The
lactate/albumin ratio might constitute an independent, readily available, and
important parameter for risk stratification in the critically ill. View Full-
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