Relationship of Lactate-Albumin Ratio with Disease Severity in Patients with Acute Pancreatitis

Acute pancreatitis (AP) is a common acute abdominal illness that can be fatal. Early determination of the severity of AP is important for the rapid initiation of effective treatments. In our study, we aimed to investigate the role of the lactate-albumin (LA) ratio assessed at the time of initial presentation in determining the severity of the disease. Our study was a retrospective and observational evaluation of patients admitted to a tertiary training and research emergency department with a diagnosis of AP who underwent lactate and albumin evaluation and abdominal computed tomography. A period of four years was evaluated. The primary goal of the study was to evaluate the efficacy of using LA ratio in determining the severity of AP. The study included 359 patients. The mean age was 57.71 ± 17.84 years, 58.2% were female, 212 (59.1%) had mild AP (MAP), and 147 (40.9%) had moderate AP to severe AP (MSAP-SAP). Seventeen of our patients died (4.7%). Mean albumin and lactate levels and LA ratio were 4.4 g/dL (4.1–4.6), 2 mmol/L (1.5–2.6), and 0.44 (0.34–0.58), respectively. The mean BISAPS and computed tomography severity index (CTSI) scores were 1. Significant differences were also found between MAP and MSAP-SAP groups in lactate, albumin, and LA ratios (p = 0.001, p < 0.001, p < 0.001, respectively). On ROC analysis, the strongest prognostic parameter among CTSI, BISAPS, lactate, albumin, and LA ratio was found to be increased CTSI score (AUC: 0.803) and LA ratio with relatively high AUC of 0.633 (95% CI 0.574–0.691). Multivariate logistic regression analysis showed that BISAPS and CTSI scores were independent risk factors. A one-point increase in the BISAPS score was associated with a 4.179-fold increase in MSAP-SAP severity (p < 0.001). A one-point increase in CTSI scores was associated with a 4.042-fold increase in MSAP-SAP severity (p < 0.001). We concluded that the LA ratio calculated at the time of presentation may be effective in determining the severity of AP. In addition, we found that BISAPS and CTSI scores, as independent variables, were statistically more powerful parameters than the LA ratio in predicting disease severity.