Role of lactate albumin ratio in predicting in-hospital mortality in sepsis patients and its comparison with quick sequential organ failure assessment (qSOFA) score – A prospective observational study

Background: Sepsis is defined as a dysregulated host immune response to an infection. According to the WHO in 2017, 49 million sepsis cases and 11 million deaths were reported. The quick Sequential Organ Failure Assessment (qSOFA) score has several disadvantages in assessing prognosis in sepsis. It was validated retrospectively based on limited country data and has not been proven useful in wide clinical settings. Lactate, in combination with serum albumin, a nutritional marker—Lactate Albumin Ratio (LAR), can be an alternative marker for predicting mortality in sepsis. Our study was aimed at assessing in-hospital mortality and also to compare both LAR and qSOFA scores in predicting outcomes in sepsis. Methods: This is a prospective observational study conducted in a tertiary care center. Results: A total of 40 patients were included. The mean age was 46.375 ± 17.4 years. Twenty-four were males and 16 were females. Fifteen patients expired, with a mortality rate of 37.5%. The mean lactate-albumin ratio in survivors was 0.76, while in non-survivors 1.77 ( P < 0.001). The mean qSOFA score in survivors and non-survivors was 2 and 2.66, respectively ( P < 0.001). LAR and q SOFA were significantly higher in non-survivors than in survivors ( P < 0.01). The area under the receiver operating characteristic (AUROC) curve value of LAR was 0.981 (95% confidence interval [CI] 0.942–1.00, P < 0.01), which was higher than that of qSOFA (0.833, 95% confidence interval [CI] 0.681–0.986, P < 0.01) for predicting mortality. Conclusions: LAR is a better predictor of mortality than qSOFA. Further studies with larger samples and wide geographic locations are needed to establish the same.