VALIDITY OF LACTATE/ALBUMIN RATIO AND LACTATE CLEARANCE IN MORTALITY PREDICTION OF CRITICALLY ILL PATIENTS WITH SEPTIC SHOCK

Background: In intensive care units, septic shock is a potentially fatal condition that has a high fatality rate. To enhance clinical results, high-risk individuals must be identified early. Traditional biomarkers such as serum lactate have been widely used for risk stratification, but their prognostic utility may be enhanced when combined with other indicators. The lactate/albumin ratio (LAR) and lactate clearance have recently been proposed as more accurate predictors of mortality in critically ill patients. So, we aimed to assess the validity of lactate to albumin (L/A) ratio and lactate clearance in 28 days mortality prediction in critically ill patients with septic shock. Methods: This prospective cohort study was conducted on critically ill patients with septic shock in the surgical and emergency intensive care units (ICUs) at the anesthesia, intensive care, and pain management departments at Zagazig University hospitals. Lactate clearance was measured in each patient in 24h and the lactate to albumin (L/A) ratio was measured in 0h,8h,16h,24h,48h. The L/A ratio (Albumin g/dl) and lactate clearance (lactate mmol/L) in relation to ICU 28-day mortality for all patients in septic shock were the main outcomes. Results: Non-survivors exhibited significantly higher lactate levels and a lactate/albumin ratio than sepsis survivors. RRT and lactate clearance were significant predictors of death, whereas the other factors were not. Conclusion: The L/A ratio is a clinical measure that predicts in-hospital mortality in sepsis more precisely than lactate levels alone. In sepsis, lactate clearance is a trustworthy biomarker that can forecast mortality.