Ann Hepatol. 2023 Jan 9:100897. doi: 10.1016/j.aohep.2023.100897. Online ahead of print.
ABSTRACT
INTRODUCTION AND OBJECTIVES: Novel predictors of prognosis in cirrhotic patients have been emerging in recent years and studies show that the lactate/albumin ratio can serve as an early prognostic marker in different patient groups. We aimed to uncover the clinical significance of the lactate/albumin ratio in hospitalized patients with acutely decompensated cirrhosis.
MATERIALS AND METHODS: A retrospective single-center cohort study was conducted in a tertiary medical center. Subjects included had an established diagnosis of liver cirrhosis and were admitted to the ICU or the Internal Medicine department with a clinical picture of acute-on-chronic liver failure between the years 2010 and 2021. The primary outcome was to assess the utility of the lactate/albumin ratio as a prognostic marker to predict mortality in hospitalized cirrhotic patients with acute-on-chronic hepatic failure.
RESULTS: Two hundred seventy-nine patients were included in this study. Univariate analysis revealed that mean WBC count, Platelet/Creatinine ratio, Aspartate Transaminase (AST), Lactate, and MELD Score were all significantly associated with the primary outcome. Multivariate analysis showed that the lactate/albumin ratio was the strongest statistically significant (p<0.001) predictor of death during hospitalization – OR 13.196 (95% CI 3.6- 48.3), followed by mean WBC count, MELD score, and serum lactate levels. A ROC curve was constructed, which resulted in an area under the curve (AUC) equal to 0.77. Crosstabs from the ROC showed a sensitivity of 66.7% and a specificity of 76.2% when the lactate/albumin ratio chosen as a cutoff was 0.9061 CONCLUSIONS: Elevated lactate/albumin ratio predicts in-hospital mortality in hospitalized cirrhotics with acute-on-chronic hepatic failure.
PMID:36632976 | DOI:10.1016/j.aohep.2023.100897
