Usefulness of lactate albumin ratio at admission to predict 28-day mortality in critically ill severely burned patients: A retrospective cohort study |
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| Affiliation: | 1. Assistance Publique—Hôpitaux de Paris (AP—HP), Groupe Hospitalier St Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, Paris, France;2. University Paris Diderot, Paris, France;3. Assistance Publique—Hôpitaux de Paris (AP—HP), Groupe Hospitalier St Louis-Lariboisière, Biochemistry Laboratory, Paris, France;4. Institut National de la Santé et de la Recherche Médicale (INSERM), INSERM UMR-S 942 Mascot, Lariboisière Hospital, Paris, France;5. INI-CRCT Network, Nancy, France;6. FHU PROMICE, Paris, France;7. Department of Anaesthesiology and Peri-operative Medicine and Critical Care Medicine, University of California, San Francisco, CA, USA;1. Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China;2. Department of Dermatology, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu 212001, China;3. School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212001, China;4. Inner Mongolia Medical University, Hohhot, Inner Mongolia 010050, China;1. Division of Plastic Surgery, Department of Surgery, Cipto Mangunkusumo Hospital/ Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No. 71, Jakarta 10430, Indonesia;2. ICTEC (Indonesian Clinical Training and Education Center), Cipto Mangunkusumo Hospital/ Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No. 71, Jakarta 10430, Indonesia;3. Medical Technology Cluster, IMERI (Indonesian Medical Education and Research Institute), Faculty of Medicine Universitas Indonesia, Education Tower, 2nd Floor, Jl. Salemba Raya No. 6, Jakarta, Indonesia;1. Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University, Al Jouf, Saudi Arabia;2. Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt;3. Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia;4. Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt;5. Department of Physical Therapy, College of Applied Medical sciences, Taif University, Taif, Saudi Arabia;6. Department of Nursing, College of Applied Medical Sciences, Jouf University, Al Jouf, Saudi Arabia;1. WFBMC Burn Center; Wake Forest Baptist Health System, USA;2. Burn Center; University Medical Center New Orleans, USA;3. Louisiana State University School of Medicine, USA;4. Wake Forest University School of Medicine, USA;1. Peking University Fourth School of Clinical Medicine, Beijing City, People’s Republic of China;2. Department of Burns, Beijing Jishuitan Hospital, Beijing City, People’s Republic of China;3. Department of Statistics, Iowa State University, Ames, IA, United States;1. Department of Plastic Surgery, James Cook University Hospital, Middlesborough, United Kingdom;2. Emergency Medicine, Royal London Hospital, London, United Kingdom;3. Cranley Clinic, 35 Devonshire Place, London, United Kingdom |
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| Abstract: | IntroductionLactate albumin ratio (LAR) has been used as a prognostic marker associated with organ failure in critically ill septic patients. LAR and its association with outcomes has never been studied in burned patients. The aim of this study was to evaluate the ability of LAR to predict 28-day mortality.MethodsA retrospective cohort study including all burn patients hospitalized in intensive care unit. The primary endpoint was the 28-day mortality.ResultsOne thousand three hundred thirty four patients were screened, and 471 were included between June 2012 and December 2018. Briefly, the population study was mainly composed by men (249, 59.1%), the median age, TBSA burned, full thickness, ABSI and IGS2 were 52 [34–68], 20 [10–40], 8 [1–23], 7 [5–9] and 25 [15–40] respectively. Fifty-two patients (12.4%) died at day 28 after admission. At admission, the LAR level was lower in 28-day survivors compared non-survivors (0.05 [0.04, 0.08] vs 0.12 [0.07, 0.26], p < 0.001 respectively). In multivariate analysis accounting for ABSI, LAR levels at admission> 0.13 was independently associated with 28-day mortality (adjusted OR = 3.98 (IC95 1.88–8.35)). The ability of LAR at admission to discriminate 28-day mortality showed an AUC identical when compared to SOFA and ABSI scores (0.81 (IC95 0.74–0.88), 0.80 (IC95 0.72–0.85) and (0.85 (IC95 0.80–0.90), p < 0.05, respectively). Patients with LAR levels ≥ 0.13 at admission had higher 28-day mortality (40.6% vs 6.8%, p < 0.001, HR 7.39 (IC95 4.28–12.76)).ConclusionAt admission, LAR is an easy and reliable marker independently associated to 28-day mortality in patients with severe burn injury, but prediction by LAR does not perform better than lactate level alone |
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| Keywords: | Lactate albumin ratio Burns Outcome Organ dysfunction Biomarker |
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