Lactate dehydrogenase to albumin ratio may predict worsening in lower RTI: Study

South Korea: The lactic dehydrogenase to albumin (LDH/ALB) ratio was discovered to be an independent predictive factor for in-hospital mortality in patients with lower respiratory tract infection (LRTI) in a recent study.

This study was conducted by Bong-Kyu Lee and the team with the objective to test the function of the lactate dehydrogenase to albumin ratio as an independent predictive factor for lower respiratory tract infection mortality in the emergency department (ED). The findings of this work were published in the American Journal of Emergency Medicine on 25th November 2021.

Researchers evaluated the electronic medical records of patients admitted to the ED for the treatment of LRTI between January 2018 and December 2020 for this study. In the emergency department, initial vital signs, laboratory data, and patient severity assessments were obtained. The LDH/ALB ratio was compared to other albumin-based ratios (blood urea nitrogen to albumin ratio, C-reactive protein to albumin ratio, and lactate to albumin ratio) and severity scales (pneumonia severity index, modified early warning score, and CURB-65 scores) that are used to predict in-hospital mortality. To find independent risk variables, multivariable logistic regression was used.

The results of this work were stated as follow:

1. The non-survivor group had a greater LDH/ALB ratio than the survivor group (median: 217.6 vs. 126.4).

2. When the area under the receiver operating characteristic curve (AUC) for predicting in-hospital mortality was compared, the LDH/ALB ratio (0.808) had a wider AUC than other albumin-based ratios and severity scales, except the blood urea nitrogen to albumin ratio.

3. The LDH/ALB ratio was found to be an independent predictor of in-hospital mortality in a multivariable logistic regression study.

The LDH/ALB ratio outperformed other albumin-based ratios and severity measures, according to the researchers. They concluded by stating that the LDH/ALB ratio might be employed as an independent predictive indicator for in-hospital mortality in LRTI patients.

Reference:

Lee BK, Ryu S, Oh SK, Ahn HJ, Jeon SY, Jeong WJ, Cho YC, Park JS, You YH, Kang CS. Lactate dehydrogenase to albumin ratio as a prognostic factor in lower respiratory tract infection patients. Am J Emerg Med. 2021 Nov 25;52:54-58. doi:10.1016/j.ajem.2021.11.028. Epub ahead of print. PMID: 34864628.