Efficacy of serum lactate/albumin ratio as a prognostic biomarker in patients with ventilator-associated pneumonia

Year 2025, Volume: 8 Issue: 1, 85 - 90, 12.01.2025

Nurcan Kırıcı Berber , Zeliha Korkmaz Dişli , Leman Acun Delen , Lale Şahin Gür , Azize Yetişgen , İlhami Berber

https://doi.org/10.32322/jhsm.1588255

Abstract

Aims: This study aims to evaluate the efficacy of the serum lactate/albumin ratio (LAR) as a prognostic marker in patients with ventilator-associated pneumonia (VAP) who are hospitalized in the intensive care unit (ICU).
Methods: This single-center retrospective observational clinical study was conducted between January 1, 2022, and October 1, 2024. The study group comprised 58 patients admitted to the ICUs of Malatya Training and Research Hospital, Turkiye, with intubation but without a diagnosis of pneumonia at the time of admission. These patients were diagnosed with VAP 48 hours after intubation. The serum LAR was calculated within the first 24 hours after admission to the ICU and correlated with mortality and morbidity.
Results: The mean age of the patients was 68 years, with the majority being over 65 years of age. Of the 58 patients included in the study, 43 (74.1%) ultimately succumbed to their illness. The LAR of those who died in the study was significantly higher than that of those who survived. The LAR was identified as a reliable predictor, exhibiting a sensitivity of 83.7% and a specificity of 60% when a cutoff value of 1.13 was applied. The survival time of patients with a LAR of ≤1.13 was significantly longer than that of patients with a ratio of >1.13.
Conclusion: In our study, the mortality prediction performance of the LAR in patients with VAP was superior to that of the serum lactate level or serum albumin level alone. Therefore, the LAR may be a useful and readily available prognostic factor for early risk stratification of VAP patients.

Keywords

Ventilator-associated pneumonia, biomarker, lactate/albumin ratio, prognostic factor

Ventilatör ilişkili pnömoni hastalarında prognostik biyobelirteç olarak serum laktat/albümin oranının etkinliği

Abstract

Amaçlar: Bu çalışmada, yoğun bakım ünitesinde (YBÜ) yatan ventilatör ilişkili pnömoni (VAP) hastalarında serum laktat/albümin oranının (LAR) prognostik bir belirteç olarak etkinliğinin değerlendirilmesi amaçlanmıştır.
Yöntemler: Bu tek merkezli retrospektif gözlemsel klinik çalışma 1 Ocak 2022 ile 1 Ekim 2024 tarihleri ​​arasında yürütülmüştür. Çalışma grubu, Türkiye Malatya Eğitim ve Araştırma Hastanesi YBÜ'lerine entübasyonla yatırılan ancak yatış sırasında pnömoni tanısı olmayan 58 hastadan oluşmuştur. Bu hastalara entübasyondan 48 saat sonra VAP tanısı konmuştur. Serum LAR, YBÜ'ye yatıştan sonraki ilk 24 saat içinde hesaplanmış ve mortalite ve morbidite ile ilişkilendirilmiştir.
Sonuçlar: Hastaların ortalama yaşı 68 olup çoğunluğu 65 yaşın üzerindedir. Çalışmaya dahil edilen 58 hastanın 43'ü (%74,1) sonunda hastalıklarına yenik düştü. Çalışmada ölenlerin LAR'ı hayatta kalanların LAR'ından önemli ölçüde daha yüksekti. LAR, 1,13'lük bir kesme değeri uygulandığında %83,7 duyarlılık ve %60 özgüllük sergileyen güvenilir bir öngörücü olarak tanımlandı. LAR'ı ≤1,13 olan hastaların sağkalım süresi, oranı >1,13 olan hastalardan önemli ölçüde daha uzundu.
Sonuç: Çalışmamızda, LAR'ın VAP'li hastalardaki mortalite öngörü performansı, serum laktat düzeyi veya serum albümin düzeyinin tek başına performansından daha üstündü. Bu nedenle, LAR, VAP hastalarının erken risk sınıflandırması için yararlı ve kolayca bulunabilen bir prognostik faktör olabilir.

Keywords

Ventilatörle ilişkili pnömoni, biyobelirteç, laktat/albümin oranı, prognostik faktör

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