Lactate dehydrogenase to albumin ratio as a prognostic factor for patients with severe infection requiring intensive care

Jeon, So Young; Ryu, Seung Ho; Oh, Suyeon; Park, Jung Soo; You, Yeonho; Jeong, Wonjoon; Ahn, Hongjoon; Kang, Changshin

doi:10.1097/md.0000000000027538

Cited by 18 publications

(17 citation statements)

References 32 publications

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“…Although any analysis of LAR has not yet been reported in the current emergency hernia surgery literature, its value was previously demonstrated as a parameter that affected mortality in severe infections requiring intensive care. [26] Other indices were also shown to associate with either disease diagnosis, clinical outcomes, morbidity, or mortality in various previous studies, such as the NPR in cardiac emergencies, IBil/Albumin in neurological and neonatal emergencies, LDH/WBC in systemic inflammation and the prognosis of Coronavirus disease-19, PAR in cancers of especially the hepatobiliary system, and NAR in sepsis and septic shock. [27][28][29][30][31][32] The results of the present study revealed that among the indices commonly used as indicators of systemic inflammation in various diseases LDH/WBC, NPR and NAR were significantly associated with strangulation in emergency anterior abdominal wall hernias.…”

Section: Discussionmentioning

confidence: 92%

Evaluation and clinical significance of predictors for strangulation and intestinal resection in emergency anterior abdominal wall hernia surgery

Buldanlı

Kesikli

Çimen

et al. 2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Emergency anterior abdominal wall hernia surgery plays a pivotal role in emergency general surgery practice. In this study, the predictive value of laboratory and imaging findings as well as demographic information and comorbidities of the patients for the recognition of strangulation and intestinal resection was investigated. METHODS:Patients over the age of 18 who were operated consecutively with an indication for emergency anterior abdominal wall hernia surgery between January 2017 and December 2019 in a single tertiary hospital were included in this retrospective cohort study. The patient population was divided into two groups according to the pre-operative findings during the emergency anterior abdominal wall hernia surgery. Group 1 consisted of cases with incarceration but without strangulation, whereas Group 2 consisted of cases with strangulation in addition to incarceration. Moreover, in evaluation for the requirement for intestinal resection, patient Group 2 was divided further into two groups, namely, as Group (1 or 2) a and Group (1 or 2) b, defining the need for intestinal resection. RESULTS:A total of 106 patients who had emergency anterior abdominal wall repair surgery due to incarcerated hernias were included in the study. The evaluation of the indices related to systemic inflammation revealed that lactate dehydrogenase to white blood cell ratio was significantly lower but neutrophil to platelet and neutrophil to albumin ratios were significantly higher in patients with strangulation, showing the significance of those systemic inflammation indices in detecting strangulation (p=0.027, p=0.035 and p=0.030, respectively). Moreover, the analysis of the patients in whom intestinal resection was required (Group 2a vs. 2b) exposed that neutrophil to albumin ratio was significantly higher in the patients with intestinal resection (p=0.036).CONCLUSION: Indices of systemic inflammation such as lactate dehydrogenase to white blood cell ratio, neutrophil to platelet ratio, and particularly neutrophil to albumin ratio may be potentially beneficial to prevent complications and improve clinical outcomes in emergency hernia surgery.

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Section: Discussionmentioning

confidence: 92%

Evaluation and clinical significance of predictors for strangulation and intestinal resection in emergency anterior abdominal wall hernia surgery

Buldanlı

Kesikli

Çimen

et al. 2023

Ulus Travma Acil Cerrahi Derg

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“…LDH is a valuable factor in determining the severity of infection. 30 Therefore, elevated LDH and CRP levels would be reliable alarm signals to note severe AU induced by infection. Moreover, as a supporter of aerobic glucose metabolism, LDH elevation marked the degree of T-cell activation.…”

Section: Discussionmentioning

confidence: 99%

Severe acute urticaria is associated with elevated plasma levels of D‐dimer

Chen,

Xu,

Liu

et al. 2023

The Journal of Dermatology

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Evaluation of the disease severity of acute urticaria (AU) is essential for adequate treatment of patients. However, there are no reliable biomarkers for such an evaluation. In our department, we observed patients with severe AU having elevated plasma D‐dimer levels. Thus, the objective of this study was to investigate the elevated D‐dimer levels in patients with severe AU in more detail. One hundred and thirty‐nine hospital patients diagnosed with severe AU were enrolled. Clinical laboratory data were collected from electronic medical records. One hundred and seventeen of the patients presented with elevated plasma D‐dimer levels. Compared to the normal group, the elevated group had a significantly higher proportion of patients who were female, younger, febrile, and had a shorter prehospital time (P < 0.05). Univariate regression analysis showed that neutrophil percentage, C‐reactive protein (CRP), and lactate dehydrogenase (LDH) levels increased as D‐dimer levels increased, while prehospital time showed the opposite trend. Multiple regression analysis was used to estimate the simultaneous effects of CRP and LDH on D‐dimer levels. Patients who responded to additional antibiotic treatment had higher levels of D‐dimer. The group with highly elevated D‐dimer levels required a higher maximum dose of daily glucocorticoids (GCs) to control the symptoms of AU. In conclusion, patients with severe AU might have elevated plasma D‐dimer levels, which are positively correlated with CRP and LDH levels. Patients with severe AU with dramatically elevated D‐dimer levels might need a higher dose of daily GCs and antibiotics to relieve symptoms. D‐dimer may be a reasonable marker to evaluate the severity of AU and guide treatment.

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“…In the literature, it has been demonstrated that the LDH/albumin ratio independently affects mortality in severe infections requiring intensive care [ 19 ] and stroke-related pneumonia [ 22 ] in lower respiratory tract infections. [ 23 ] High LDH levels are an interesting biomarker associated with poor outcomes in patients with previous viral infections.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15][16][17][18] Several studies have used the LDH/albumin ratio as a prognostic factor in pneumonia patients. [19] Patients hospitalized with COVID-19 need regular monitoring of vital signs and, where possible, early recognition of the deteriorating patient and biomarkers that predict prognosis. The present study was designed to confirm whether LDH/albumin ratio can be used as an independent prognostic factor in patients with severe ARDS due to COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Lactate dehydrogenase/albumin ratio as a prognostic factor in severe acute respiratory distress syndrome cases associated with COVID-19

Sipahioğlu

Onuk

2022

Medicine

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Background: Patients with severe acute respiratory distress syndrome (ARDS) have high mortality rates; therefore, new biomarkers are necessary to predict the prognosis in the early stages. Serum lactate dehydrogenase (LDH) level is a specific marker of lung damage, but it is not sensitive because it is affected by several factors. This study aimed to determine whether the LDH/albumin ratio could be used as a prognostic biomarker in patients with severe ARDS due to COVID 19.Methods: Tertiary intensive care unit (ICU) patients with severe ARDS and confirmed COVID-19 diagnosis between August 1, 2020, and October 31, 2021, were included. The demographic and clinical characteristics of the patients were recorded from the hospital databases, together with laboratory results on the day of admission to the ICU and the length of stay in the ICU and hospital. LDH/albumin, lactate/albumin, C-reactive protein (CRP)/albumin, and BUN/albumin ratios were calculated. Logistic regression analysis was performed to determine independent risk factors affecting mortality.Results: Nine hundred and five patients hospitalized in a tertiary ICU were evaluated. Three hundred fifty-one patients with severe ARDS were included in this study. The mortality rate of the included patients was 61.8% (of 217/351). LDH/albumin, lactate/albumin, and BUN/albumin ratios were higher in the nonsurvivor group (P < .001). The area under the curve (AUC) from the receiver operating characteristic analysis that predicted in-hospital mortality was 0.627 (95% confidence intervals (CI): 0.574-0.678, P < .001) for the LDH/albumin ratio, 0.605 (95% CI: 0.551-0.656, P < .001) for lactate/albumin, and 0.638 (95% CI: 0.585-0.688, P < .001) for BUN/albumin. However, LDH/albumin ratio was independently associated with mortality in multivariate logistic regression analysis.Conclusion: LDH/albumin ratio can be used as an independent prognostic factor for mortality in patients with severe ARDS caused by COVID-19.

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Lactate dehydrogenase to albumin ratio as a prognostic factor for patients with severe infection requiring intensive care

Abstract: Supplemental Digital Content is available in the text

Cited by 18 publications

References 32 publications

Evaluation and clinical significance of predictors for strangulation and intestinal resection in emergency anterior abdominal wall hernia surgery

Evaluation and clinical significance of predictors for strangulation and intestinal resection in emergency anterior abdominal wall hernia surgery

Severe acute urticaria is associated with elevated plasma levels of D‐dimer

Lactate dehydrogenase/albumin ratio as a prognostic factor in severe acute respiratory distress syndrome cases associated with COVID-19

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