Role of lactate-to-albumin ratio in predicting in-hospital mortality of geriatric patients admitted to the emergency department

In this study, we aimed to evaluate the role of the lactate-to-albumin ratio initially measured in the emergency department in predicting in-hospital mortality in a geriatric patient population.

This study was a retrospective and observational evaluation of patients with nontraumatic injuries >65 years of age who admitted in a tertiary training and research hospital emergency department and had available lactate and albumin values. The patients were evaluated over a 6-month period. The primary outcome of this study was an examination of the relationship between lactate-to-albumin (LA) ratio and in-hospital mortality.

The data of 2310 patients were included in the statistical analysis. In the nonsurvivor group, lactate levels (2.8 mmol/L [1.7–5.2 mmol/L] vs 2.0 mmol/L [1.5–2.7 mmol/L], p < 0.001) and LA ratios were increased (0.85 [0.56–1.58] vs 0.51 [0.32–0.70], p < 0.001), but albumin levels were decreased (3.4 g/dL [2.7–4.0 g/dL] vs 4.0 g/dL [3.7–4.3 g/dL], p < 0.001). Increased LA ratio was a stronger predictor of mortality (0.752; 95% confidence interval [CI] 0.716–0.788; p < 0.001) than lactate level (0.684 [95% CI 0.645–0.723], p < 0.001) and albumin level (0.743 [95% CI 0.704–0.781], p < 0.001) according to the receiver operating characteristic analysis. In the multivariate logistic regression analysis, albumin levels <3.55 g/dL (odds ratio [OR] 2.435; 95% CI 1.70–3.46; p < 0.001) and LA ratios >0.68 (OR 3.971; 95% CI 2.31–6.81; p < 0. 001) were found to be independent variables of mortality, whereas lactate levels >2.55 mmol/L (OR 1.194; 95% CI 1.71–2.02; p = 0.507) were not an independent variable.

According to the results of this study, lactate level, albumin level, and LA ratio can be used to predict in-hospital mortality. In addition, LA ratio is a stronger independent predictor of in-hospital mortality than lactate and albumin levels.