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 in managing critically sick patients with high fatality rates and hence must develop effective prognostic biomarkers. Patients in critical care can be stratified with pinpoint accuracy using the lactate-to-albumin (L/A) ratio. However, the significance of the L/A ratio in determining the prognosis of infants who are seriously ill is still up for debate. Therefore, this research aimed to assess the L/A ratio’s prognostic performance in predicting in-hospital mortality in unselected PICU patients with a critical illness.

The sample for this study came from a single institution. The Pediatric Intensive Care (PIC) database was mined for clinical information on 8,832 critically ill children and teenagers between the ages of 28 days and 18 years from the years 2010 to 2018. The rate of deaths that occurred while patients were hospitalized was the main measure of success. When comparing survivors with non-survivors, those who did not make it had a greater L/A ratio (P<0.001). Mortality rates in hospitals were shown to be significantly linked to L/A ratios (OR 1.44, 95% CI 1.31-1.59, P<0.001). L/A ratio had a greater area under the receiver operating characteristic curve (AUROC) than lactate level alone (0.74vs 0.70) for predicting in-hospital mortality (P<0.001). 

The L/A ratio was significantly related to in-hospital mortality across all age and primary disease categories (P<0.05). According to the results of our research, the L/A ratio may be a more accurate clinical tool than lactate level alone for predicting in-hospital death in critically unwell children. To fully assess the L/A ratio’s prognostic usefulness in critical illness, further prospective studies are needed, as this one was conducted using historical data.