Lactate–albumin ratio improves combined predictive value of qSOFA and MEWS for 30-day mortality in ICU patients with sepsis: A retrospective cohort study

Evaluating disease severity and predicting adverse outcomes using various risk prediction tools in early disease stages is essential to reduce sepsis-related mortality. Unfortunately, there is still no clear consensus on the best score. The present study aimed to develop and validate a multivariable risk prediction model for 30-days mortality by combining the lactate-to-albumin (L/A) ratio, Modified Early Warning Score (MEWS), and quick Sequential Organ Failure Assessment (qSOFA) in sepsis patients admitted to the intensive care unit (ICU). This retrospective study included ICU patients with suspected sepsis. We computed L/A ratio, MEWS, and qSOFA within 24 hours of ICU admission. Patients were followed until either death/hospital discharge or 30 days, whichever came first. The predictive performance of each scoring system and their combinations was assessed using logistic regression and receiver operating characteristic curve analyses. A total of 130 patients with sepsis admitted to the ICU were included in the study. The mortality rate was 63.07% (82/130). A higher L/A ratio, MEWS, and qSOFA were found to be associated with mortality in ICU sepsis patients. A statistically significant difference in terms of predicting mortality was demonstrated in the pairwise comparison after combining the L/A ratio with both the qSOFA and MEWS (difference between areas: -0.098, P = .011 and difference between areas: -0.098, P = .013 respectively). Mortality models combining L/A ratio with selected clinical variables have improved mortality prediction performance compared with models that use MEWS and qSOFA alone. The L/A ratio at ICU admission provide valuable prognostic information for predicting 30-days mortality in sepsis patients. Combining these ratio with MEWS and qSOFA improves the accuracy of predicting mortality in patients with sepsis.