Serum Lactate/Albumin Ratio as a Predictor of Morbidity and Mortality in Children and Adolescents with Severe Sepsis and Septic Shock

Background: Sepsis is the 10^th leading cause of death and one of the leading causes for admission to the intensive care unit. Combining serum lactate and albumin in the form of lactate albumin ratio could yield more accurate prediction about prognosis of critically ill patients especially in septic patients.
The aim of this work was to to evaluate the ability of Lactate/albumin ratio to predict outcome regarding morbidity, mortality and disease severity.
Methods: This study is done as a case control study that enrolled fifty one critically ill infants and children (cases group), aged from 1 year to 14 years, with the criteria of severe sepsis or septic shock during the duration from  October 2023 to March 2024 at Al-Hussein university hospital. 21 healthy infants and children of matched age and sex were included as a control group. All studied patients were subjected to history and examination, laboratory investigations including serum albumin, serum lactate in day 0 and 1 using enzymatic colorimetric, CBC, ESR, CRP, Liver function test and renal function test.
Results: Lactate/albumin ratio at day 0 could significantly predict sepsis with area under the curve of 1, P value <0.001, and at cut-off value >0.16 ng/mL with 100% sensitivity, 100% specificity, 100% positive predictive value (PPV) and 100% negative predictive value (NPV). Lactate/albumin ratio at day 1 could significantly predict sepsis with area under the curve of 0.998, P value <0.001, and at cut-off value >0.12 ng/mL with 100% sensitivity, 85.71% specificity, 94.4% PPV and 100% NPV.
Conclusions: The lactate/albumin ratio could serve as useful biomarkers integrated with a panel for risk-stratification, prognosis and management of paediatric patients with sepsis/septic shock.