Lactate/albumin ratio as an indicator of mortality in patients hospitalized with ACLF at the Juárez Hospital in Mexico.

Introduction and Objectives: Albumin and lactate are markers of systemic inflammation, which are altered by their hepatic metabolism; however, they can be useful indicators of mortality in patients with cirrhosis. To determine the association between lactate/albumin ratio levels and mortality in pat...

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Main Authors: G. Bretón-Arroy, LA. Robles-Casanova, M. Coutiño-Flores, MR. Herrero-Maceda, SMI. Mejia-Loza
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Annals of Hepatology
Online Access:http://www.sciencedirect.com/science/article/pii/S1665268125001140
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author G. Bretón-Arroy
LA. Robles-Casanova
M. Coutiño-Flores
MR. Herrero-Maceda
SMI. Mejia-Loza
author_facet G. Bretón-Arroy
LA. Robles-Casanova
M. Coutiño-Flores
MR. Herrero-Maceda
SMI. Mejia-Loza
author_sort G. Bretón-Arroy
collection DOAJ
description Introduction and Objectives: Albumin and lactate are markers of systemic inflammation, which are altered by their hepatic metabolism; however, they can be useful indicators of mortality in patients with cirrhosis. To determine the association between lactate/albumin ratio levels and mortality in patients with ACLF. Materials and Patients: A retrospective and observational cohort study was conducted. Eighty-five patients diagnosed with ACLF according to the EASL-CLIF criteria were included from February 2022 to May 2024. Patients with hepatocellular carcinoma were excluded. Data analysis was performed using GraphPad Prism version 10.2.3 and Microsoft Excel software. An ROC curve was performed to establish the cutoff point of the lactate/albumin ratio, as well as determine the sensitivity and specificity of the model to predict 28-day mortality. Results: Eighty-five patients were included, 68 (80%) men and 17 (20%) women; average age 52.4 years (39 -80). Alcohol consumption was the main cause of cirrhosis in 74 (87.05%), autoimmune diseases in 7 (8.23%), and MASLD in 4 (4.70%) (Table 1). 12 patients (14.11%) had ACLF grade 1, 29 (34.11%) grade 2 and 44 (51.76%) grade 3. With failure: kidney 61 (71.76%), liver 57 (67.05%), brain 49 (57.64%), coagulation 37 (43.52%), respiratory 15 (17.64%) and circulatory 5 (5.88%) (Table 1). 37 (43.52%) died within the first 28 days. The cutoff point of the lactate/albumin ratio was 1.74 (AUC 0.87), with a p value <0.0001, sensitivity 71.7% and specificity 58.8% (95% CI) (Figure 1). Conclusions: The cutoff point of the lactate/albumin ratio of 1.74 allows for the objective prediction of mortality in patients with ACLF using easily accessible laboratory tests.
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spelling doaj-art-4816759bc90d45929ddac83c77e3e6462025-08-20T02:12:45ZengElsevierAnnals of Hepatology1665-26812025-04-013010189010.1016/j.aohep.2025.101890Lactate/albumin ratio as an indicator of mortality in patients hospitalized with ACLF at the Juárez Hospital in Mexico.G. Bretón-Arroy0LA. Robles-Casanova1M. Coutiño-Flores2MR. Herrero-Maceda3SMI. Mejia-Loza4Gastroenterology Department, Hospital Juárez, México City, MexicoGastroenterology Department, Hospital Juárez, México City, MexicoGastroenterology Department, Hospital Juárez, México City, MexicoGastroenterology Department, Hospital Juárez, México City, MexicoGastroenterology Department, Hospital Juárez, México City, MexicoIntroduction and Objectives: Albumin and lactate are markers of systemic inflammation, which are altered by their hepatic metabolism; however, they can be useful indicators of mortality in patients with cirrhosis. To determine the association between lactate/albumin ratio levels and mortality in patients with ACLF. Materials and Patients: A retrospective and observational cohort study was conducted. Eighty-five patients diagnosed with ACLF according to the EASL-CLIF criteria were included from February 2022 to May 2024. Patients with hepatocellular carcinoma were excluded. Data analysis was performed using GraphPad Prism version 10.2.3 and Microsoft Excel software. An ROC curve was performed to establish the cutoff point of the lactate/albumin ratio, as well as determine the sensitivity and specificity of the model to predict 28-day mortality. Results: Eighty-five patients were included, 68 (80%) men and 17 (20%) women; average age 52.4 years (39 -80). Alcohol consumption was the main cause of cirrhosis in 74 (87.05%), autoimmune diseases in 7 (8.23%), and MASLD in 4 (4.70%) (Table 1). 12 patients (14.11%) had ACLF grade 1, 29 (34.11%) grade 2 and 44 (51.76%) grade 3. With failure: kidney 61 (71.76%), liver 57 (67.05%), brain 49 (57.64%), coagulation 37 (43.52%), respiratory 15 (17.64%) and circulatory 5 (5.88%) (Table 1). 37 (43.52%) died within the first 28 days. The cutoff point of the lactate/albumin ratio was 1.74 (AUC 0.87), with a p value <0.0001, sensitivity 71.7% and specificity 58.8% (95% CI) (Figure 1). Conclusions: The cutoff point of the lactate/albumin ratio of 1.74 allows for the objective prediction of mortality in patients with ACLF using easily accessible laboratory tests.http://www.sciencedirect.com/science/article/pii/S1665268125001140
spellingShingle G. Bretón-Arroy
LA. Robles-Casanova
M. Coutiño-Flores
MR. Herrero-Maceda
SMI. Mejia-Loza
Lactate/albumin ratio as an indicator of mortality in patients hospitalized with ACLF at the Juárez Hospital in Mexico.
Annals of Hepatology
title Lactate/albumin ratio as an indicator of mortality in patients hospitalized with ACLF at the Juárez Hospital in Mexico.
title_full Lactate/albumin ratio as an indicator of mortality in patients hospitalized with ACLF at the Juárez Hospital in Mexico.
title_fullStr Lactate/albumin ratio as an indicator of mortality in patients hospitalized with ACLF at the Juárez Hospital in Mexico.
title_full_unstemmed Lactate/albumin ratio as an indicator of mortality in patients hospitalized with ACLF at the Juárez Hospital in Mexico.
title_short Lactate/albumin ratio as an indicator of mortality in patients hospitalized with ACLF at the Juárez Hospital in Mexico.
title_sort lactate albumin ratio as an indicator of mortality in patients hospitalized with aclf at the juarez hospital in mexico
url http://www.sciencedirect.com/science/article/pii/S1665268125001140
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