Año 2024 / Volumen 116 / Número 10
Original
Comparison of lactate/albumin ratio and established scoring systems for predicting mortality in critically ill cirrhotic patients

539-545

DOI: 10.17235/reed.2024.10450/2024

Nazlıhan Boyacı Dundar, Kamil İnci, Melda Turkoglu, Gulbin Aygencel,

Resumen
Background: critically ill cirrhotic patients may present a serious clinical condition defined as acute-on-chronic liver failure with high mortality. While established scoring systems like Child-Pugh and Model for End-stage Liver Disease (MELD) offer prognostic insights, their limitations warrant exploration of alternative markers. The lactate/albumin ratio (LAR) serves as a potential prognostic indicator in critical care settings, yet its utility in cirrhotic patients remains underexplored. Methods: one hundred and seventy-five critically ill cirrhotic patients were assessed in this retrospective cohort study. Clinical severity scores, including Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and Chronic Liver Failure-Organ Failure Score (CLIF-OF) were compared with LAR along with traditional liver failure scoring systems. Logistic regression and receiver operating characteristic (ROC) curve analysis were used to evaluate prognostic performance. Results: Intensive Care Unit (ICU) nonsurvivors had significantly higher scores in all liver failure and clinical severity scores compared to survivors (p < 0.001). Median LAR was significantly higher in nonsurvivors (p < 0.001). ROC analysis revealed comparable prognostic accuracy between LAR, APACHE II, SOFA, and CLIF-OF scores in predicting ICU mortality. Logistic regression identified SOFA score at 48th hour, LAR, and requirement of mechanical ventilation as independent predictors of ICU mortality. Conclusion: LAR demonstrates promising prognostic utility in predicting ICU mortality among critically ill cirrhotic patients, complementing established scoring systems. Early reassessment using SOFA score at 48th hour may guide therapeutic interventions and improve patient outcomes. Further prospective studies are warranted to validate these findings and optimize clinical management strategies.
Resumen coloquial
Critically ill cirrhotic patients are a vulnerable population characterized by numerous complications related to advanced liver disease. Assessing the prognosis of these patients is crucial for clinical decision-making due to the increased morbidity and mortality. In recent years, the lactate/albumin ratio has gained attention for short-term mortality in critical care settings. This study aimed to evaluate the prognostic performance of the serum lactate/albumin ratio with established scoring systems in cirrhotic patients and its relationship with clinical severity scores in critically ill patients. For this purpose, a retrospective cohort study was conducted. The serum lactate/albumin ratio demonstrates a promising prognostic use to predict ICU mortality among critically ill cirrhotic patients, complementing established scoring systems. Early reassessment using the Sequential Organ Failure Assessment score at 48th hours may guide therapeutic interventions and improve patient outcomes.
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Boyacı Dundar N, İnci K, Turkoglu M, Aygencel G. Comparison of lactate/albumin ratio and established scoring systems for predicting mortality in critically ill cirrhotic patients. 10450/2024


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Ficha Técnica

Recibido: 02/04/2024

Aceptado: 02/06/2024

Prepublicado: 14/06/2024

Publicado: 09/10/2024

Tiempo de revisión del artículo: 60 días

Tiempo de prepublicación: 73 días

Tiempo de edición del artículo: 190 días


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