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PROGNOSTIC VALUE OF THE RATIO OF LACTATE TO ALBUMIN IN PREDICTING MORTALITY IN CHILDREN WITH SEPTIC SHOCK AT CAN THO CHILDREN'S HOSPITAL IN 2022-2024
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Abstract
Background: The lactate/albumin ratio is considered a valuable marker for predicting mortality in patients with septic shock. However, most studies on this topic have been conducted in adults, and there is a lack of data on this index in Vietnam. Objectives: 1). To describe the clinical, paraclinical characteristics and mortality rate in children with septic shock at Can Tho Children's Hospital; 2.) To determine the prognostic value of the lactate/albumin ratio for mortality in children with septic shock. Materials and methods: This was a descriptive cross-sectional study with case series analysis of 32 children diagnosed with septic shock at Can Tho Children's Hospital from July 2022 to February 2024. Results: Among the 32 children with septic shock who met the inclusion criteria, 53.1% were male and 34.4% were infants. The main route of infection was the gastrointestinal tract (56,3%). The positive blood culture rate was 21,9%. The mortality rate was 56.3%, with 6.3% of the children dying within 24 hours of being diagnosed with shock. Compared to the surviving group, the non-surviving group exhibited significantly higher lactate and lactate/albumin levels, while albumin levels were significantly lower (p < 0.001). For predicting mortality in children with septic shock, the area under the receiver operating characteristic (ROC) curve (AUROC) for the lactate/albumin ratio was 0.89 (95% CI: 0.78-1.00), with a cut-off point of 1.6 (sensitivity: 88.9%, specificity: 78.6%). The AUROC for lactate alone was 0.88 (95% CI: 0.76-1.00), with a cut-off point of 3.9 (sensitivity: 94.4%, specificity: 71.4%). The lactate/albumin ratio had lower sensitivity but higher specificity than lactate alone. Conclusion: The mortality rate of children with septic shock at Can Tho Children's Hospital is high and the lactate/albumin ratio provides very good prognostic value for mortality in children with septic shock.
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Keywords
Lactate/albumin ratio, lactate, albumin, mortality, septic shock
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