Prognostic evaluation of the lactate/albumin, neutrophil/lymphocyte and platelets/lymphocytes ratios in elderly patients with sepsis
Keywords:
Sepsis, prognosis, geriatrics, neutrophil/lymphocyte, platelet/lymphocyte.Abstract
Introduction: The incidence and mortality rates are much higher in the elderly with sepsis than in younger patients.
Objective: To evaluate the risk of death in elderly patients admitted with sepsis, using the lactate/albumin, neutrophil/lymphocyte and platelets/lymphocytes ratios.
Material and Methods: An observational, analytical, cross-sectional and retrospective study was conducted on patients aged 60 years or older with sepsis admitted to the intensive care unit of “Aleida Fernández Chardiet” Teaching Clinical Surgical Hospital between 2018 and 2020. The study universe was composed of 144 patients.
Results: During this period, 52.1% of the patients died. The SOFA, APACHE II and SAPS 3 scores showed mean differences in the discharges. The lactate/albumin ratio had an area under de curve of 0.74 (p=0.000), which was higher than neutrophil/lymphocyte (0.60) and platelet/lymphocyte ratios (0.58). The cut-off point for the lactate/albumin ratio was 0.05 with a sensitivity of 76% and a specificity of 63%, the highest compared to the neutrophil/lymphocyte and platelet/lymphocyte ratios. The lactate/albumin ratio was the only one that was directly related to organ dysfunction (p=0.041). In general, 99 patients presented a lactate/albumin ratio ≥0.05 and 64.6% did not survive. These patients had a 5.7 (95 % CI 2.6-12.5) times higher risk of dying compared to those with a lower lactate/albumin ratio (p=0.000).
Conclusions: The lactate/albumin ratio was able to predict death in the elderly patients studied, not even so with the neutrophil/lymphocyte ratio and the platelet/lymphocyte ratio.
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