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Lactate/albumin ratio for the prediction of the development of sepsis-induced acute kidney injury in the emergency department
Journal of the Korean Society of Emergency Medicine ; : 22-32, 2019.
Artigo em Coreano | WPRIM | ID: wpr-758443
ABSTRACT

OBJECTIVE:

The early prediction of acute kidney injury (AKI) in sepsis and the provision of prompt treatment may improve the outcomes. This study investigated the efficacy of the lactate/albumin ratio (LAR) in predicting severe AKI in cases of septic shock.

METHODS:

This retrospective, observational cohort study was performed on patients integrated prospectively in a critical pathway of early-goal-directed therapy (EGDT)/SEPSIS. Adult patients with septic shock, who were admitted to the emergency department with a normal kidney function or stage 1 disease based on the Acute Kidney Injury Network classification between January 1, 2014 and September 30, 2017, were analyzed. The outcomes were the development of sepsis-induced severe AKI within 7 days.

RESULTS:

A total of 343 patients were enrolled. An increase in the LAR value at admission (odds ratio [OR], 1.85; P=0.001) was a strong independent predictor of the development of severe AKI. The increasing predictability of AKI was closely associated with a L/A ratio≥0.794 at admission (OR, 14.66; P < 0.001). The area under the receiver operating characteristic curve value of the L/A ratio (0.821; 95% confidence interval [CI], 0.774–0.861; P < 0.01) was higher than that of lactate (0.795; 95% CI, 0.747–0.838; P < 0.01) for predicting severe AKI (P=0.032).

CONCLUSION:

L/A ratio was found to be an independent predictor of the development of severe AKI in septic shock. The prognostic performance of the L/A ratio for predicting AKI of critically ill sepsis patients was superior to that of lactate measurements.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Prognóstico / Choque Séptico / Estudos Prospectivos / Estudos Retrospectivos / Curva ROC / Estudos de Coortes / Classificação / Estado Terminal / Sepse / Procedimentos Clínicos Tipo de estudo: Estudo de etiologia / Guia de Prática Clínica / Estudo de incidência / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Adulto / Humanos Idioma: Coreano Revista: Journal of the Korean Society of Emergency Medicine Ano de publicação: 2019 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Prognóstico / Choque Séptico / Estudos Prospectivos / Estudos Retrospectivos / Curva ROC / Estudos de Coortes / Classificação / Estado Terminal / Sepse / Procedimentos Clínicos Tipo de estudo: Estudo de etiologia / Guia de Prática Clínica / Estudo de incidência / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Adulto / Humanos Idioma: Coreano Revista: Journal of the Korean Society of Emergency Medicine Ano de publicação: 2019 Tipo de documento: Artigo