The following is the summary of “Lactate/albumin ratio as a predictor of in-hospital mortality in critically ill children” published in the December 2022 issue of Pediatrics by Wang, et al.

Clinicians in pediatric intensive care units (PICU) face a significant challenge when confronted with the management of critically sick patients with high fatality rates: identifying adequate prognostic biomarkers. Adults in critical care can be stratified with pinpoint accuracy using the lactate/albumin (L/A) ratio. Predicting outcomes of severely ill children using the L/A ratio is an area of research that has yet to yield definitive results. This study sought to assess the prognostic performance of the L/A ratio in predicting in-hospital mortality in unselected PICU patients with a critical illness.

The participants were all from the same location. Hence the results can only be generalized. From 2010 to 2018, clinical data for 8,832 children in the pediatric intensive care (PIC) database were collected. These patients’ ages ranged from 28 days to 18 years. The hospital mortality rate was the main measure of success. Non-survivors had a greater L/A ratio than survivors (P<0.001). The L/A ratio was found to have a statistically significant relationship with hospital mortality (OR 1.44, 95% CI 1.31-1.59, P<0.001), as determined by logistic regression analysis. Predicting in-hospital mortality using the L/A ratio was more accurate than with just lactate level (0.74 vs. 0.70, P< 0.001).

The L/A ratio was found to have a statistically significant relationship with in-hospital mortality across all age and primary disease categories (P<0.05). Their results suggested that the L/A ratio might be used as a clinical tool to predict in-hospital mortality in critically unwell children more effectively than lactate level alone. The study’s retrospective nature calls for more prospective research into the predictive power of the L/A ratio in critical illness.