Prognostic value of the lactate-albumin difference for predicting in-hospital mortality in critically ill patients with sepsis

Objective: To evaluate the prognostic performance of the lactate-albumin difference (LAD), maximum lactate levels, and the Sequential Organ Failure Assessment (SOFA) score taken on the first day in critically ill patients with sepsis, on in-hospital mortality and 90-day survival. Patients and Methods: Data from the Medical Information Mart for Intensive Care III (MIMIC III) version 1.4 were evaluated retrospectively. The first day data of adult patients with sepsis diagnosed according to the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) criteria were recorded. The effectiveness of all diagnostic modalities on admission was analyzed to predict in-hospital and 90-day survival. Results: In-hospital mortality was 20.3% among the 2270 patients included in this study. The area below the receiver operating characteristic curve (AUC) value of the LAD was higher than lactate for predicting mortality (AUC, 0.691; 95% confidence interval [CI], 0.663-0.718; p< 0.01, and AUC, 0.675; 95% CI, 0.646-0.703; p< 0.01, respectively), and the AUC of SOFA score was the highest (AUC, 0.716; 95% CI, 0.663-0.718). The optimal cutoff of LAD was 0.7. Conclusion: In addition to its easy and simple calculability relative to the SOFA, the prognostic performance of LAD was superior to maximum lactate levels for predicting in-hospital and 90-day survival in adult patients with sepsis.