The usefulness of lactate/albumin ratio, C-reactive protein/albumin ratio, procalcitonin/albumin ratio, SOFA, and qSOFA in predicting the prognosis of patients with sepsis who presented to emergency departments

被引：5

作者：

Yoo, Kyung Hun ^{[1
,10
]}

Choi, Sung-Hyuk ^{[2
]}

Suh, Gil Joon ^{[3
]}

Chung, Sung Phil ^{[4
]}

Choi, Han Sung ^{[5
]}

Park, Yoo Seok ^{[6
]}

Jo, You Hwan ^{[7
]}

Shin, Tae Gun ^{[8
]}

Lim, Tae Ho ^{[1
,9
]}

Kim, Won Young ^{[9
]}

Lee, Juncheol ^{[1
,10
]}

机构：

[1] Hanyang Univ, Coll Med, Dept Emergency Med, Seoul, South Korea

[2] Korea Univ, Guro Hosp, Dept Emergency Med, Seoul, South Korea

[3] Seoul Natl Univ Hosp, Dept Emergency Med, Seoul, South Korea

[4] Gangnam Severance Hosp, Dept Emergency Med, Seoul, South Korea

[5] Kyung Hee Univ Hosp, Dept Emergency Med, Seoul, South Korea

[6] Yonsei Univ, Coll Med, Dept Emergency Med, Seoul, South Korea

[7] Seoul Natl Univ, Bundang Hosp, Dept Emergency Med, Seoul, Gyeonggi Do, South Korea

[8] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Emergency Med, Seoul, South Korea

[9] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Emergency Med, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea

[10] Hanyang Univ Hosp, Dept Emergency Med, Seoul, South Korea

来源：

AMERICAN JOURNAL OF EMERGENCY MEDICINE | 2024年 / 78卷

关键词：

Sepsis; Septic shock; Sequential organ failure assessment; Lactate to albumin ratio; Predictive value; Emergency department; INTERNATIONAL CONSENSUS DEFINITIONS; FAILURE ASSESSMENT SCORE; ORGAN FAILURE; SEPTIC SHOCK; MORTALITY; LACTATE; CRITERIA;

D O I：

10.1016/j.ajem.2023.12.028

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose: Early identification of sepsis with a poor prognosis in the emergency department (ED) is crucial for prompt management and improved outcomes. This study aimed to examine the predictive value of sequential organ failure assessment (SOFA), quick SOFA (qSOFA), lactate to albumin ratio (LAR), C-reactive protein to albumin ratio (CAR), and procalcitonin to albumin ratio (PAR), obtained in the ED, as predictors for 28-day mortality in patients with sepsis and septic shock. Materials and methods: We included 3499 patients (aged >= 19 years) from multicenter registry of the Korean Shock Society between October 2015 and December 2019. The SOFA score, qSOFA score, and lactate level at the time of registry enrollment were used. Albumin, C-reactive protein, and procalcitonin levels were obtained from the initial laboratory results measured upon ED arrival. We evaluated the predictive accuracy for 28-day mortality using the area under the receiver operating characteristic (AUROC) curve. A multivariable logistic regression analysis of the independent predictors of 28-day mortality was performed. The SOFA score, LAR, CAR, and PAR were converted to categorical variables using Youden's index and analyzed. Adjusting for confounding factors such as age, sex, comorbidities, and infection focus, adjusted odds ratios (aOR) were calculated. Results: Of the 3499 patients, 2707 (77.4%) were survivors, whereas 792 (22.6%) were non-survivors. The median age of the patients was 70 (25th-75th percentiles, 61-78), and 2042 (58.4%) were male. LAR for predicting 28day mortality had the highest AUROC, followed by the SOFA score (0.715; 95% confidence interval (CI): 0.69-0.74 and 0.669; 95% CI: 0.65-0.69, respectively). The multivariable logistic regression analysis revealed that the aOR of LAR >1.52 was 3.75 (95% CI: 3.16-4.45), and the aOR, of SOFA score at enrollment >7.5 was 2.67 (95% CI: 2.25-3.17). Conclusion: The results of this study showed that LAR is a relatively strong predictor of sepsis prognosis in the ED setting, indicating its potential as a straightforward and practical prognostic factor. This finding may assist healthcare providers in the ED by providing them with tools to risk -stratify patients and predict their mortality. (c) 2023 Elsevier Inc. All rights reserved.

引用

页码：1 / 7

页数：7