The Application Value Of Lactate/albumin Ratio On Prognosis Of Severe Pneumonia

Objective:To observe the predictive value of lactate/albumin ratio on condition and prognosis of patients with severe pneumonia.Methods:Retrospective analysis a total of 141 pneumonia patients admitted into Intensive care unit of Fujian Provincial Hospital from January 2015 to June 2018,90 patients with severe pneumonia and 51 patients with none severe pneumonia.Comparing basic information and blood lactate and serum albumin of them.According to the therapeutic effect of 28-day,severe pneumonia patients were divided into recovery group and deterioration group.The levels of blood lactate and serum albumin were measured immediately after ICU arrival,further more calculating lactate/albumin ratio.By comparison the above index in two groups,whether the differences were statistically significant.Using the receiver operating characteristic curve(ROC)to diagnose and predictive performance of lactate,albumin and lactate/albumin ratio.Results:The level of blood lactate of severe pneumonia group(1.87 � 1.36mmol/L)was higher than that of none severe pneumonia(1.50 � 0.77mmol/L),while the level of serum albumin of severe pneumonia group(27.09 � 5.33g/L)was lower than that of none severe pneumonia(33.75 � 7.35g/L),the difference were statistically significant(All P < 0.05).Moreover,the level of blood lactate of deterioration group(2.38 � 1.69mmol/L)was higher than that of recovery group(1.37 � 0.65mmol/L),while the level of serum albumin of deterioration group(25.86 � 5.25g/L)was lower than that of recovery group(28.26 � 5.20g/L),the difference were statistically significant(All P < 0.05).Further more,the lactate/albumin ratio of deterioration group(0.09 � 0.07)was higher than that of recovery group(0.05 � 0.02),the difference were statistically significant(P<0.05).There was a positive correlation between the lactate/albumin ratio and SOFA score(r=0.312,P=0.003),while was better than that of lactate and SOFA score(r=0.254,P=0.016)and that of albumin and SOFA score(r =-0.241,P = 0.022).Besides,there was a positive correlation between the lactate/albumin ratio and APACHE? score(r=0.215,P=0.042),while there was no correlation between lactate or albumin and APACHE? score(P > 0.05).The area under ROC curve(AUC)of lactate,albumin and lactate/albumin ratio of discharge predicting the condition and prognosis were 0.684,0.612 and 0.725,respectively,95% confidence interval(95%CI)were(0.577,0.778),P = 0.001;(0.503,0.713),P = 0.062;(0.621,0.814),P <0.001.Obviously,the predictive value of lactate/albumin ratio was higher than others.The optimal cut-off of the lactate/albumin ratio was 0.049,while the sensitivity and specificity were 72.7% and 63.0% respectively.Conclusions:The predictive value of lactate/albumin ratio on condition and prognosis of patients with severe pneumonia was better than that of blood lactate or serum albumin alone.The lactate/albumin ratio can be used as indicator of condition and prognosis of patients with severe pneumonia.