Red cell distribution width and lactate albumin ratio as prognostic markers for mortality in sepsis and septic shock patients

Abstract

Background: Red cell distribution Width (RDW) as well as lactate albumin ratio are studied due to their prognostic ability for cases having sepsis. This work was aimed at finding the RDW as well as lactate/albumin ratio utility as prognostic markers among cases having sepsis or septic shock.Methods: Our prospective observational study was carried out on 70 patients whose ages fell between eighteen to sixty yrs., exhibiting clinical criteria either septic shock or sepsis. RDW and lactate albumin ratio on the first, third, seventh, fourteenth, as well as 21st days were measured in all cases. Results: Lactate/Albumin ratio can significantly predict mortality (P = 0.001 and AUC = 0.751) at cut-off >1.5 with 73.91% sensitivity, 61.70% specificity, 45.57% PPV, 82.86% NPV and 0.420 Youden index J. RDW can significantly predict mortality (P = 0.012 and AUC = 0.698) at cut-off ≥16% with 69.57% sensitivity, 48.94% specificity, 40.00% PPV, 76.67% NPV and 0.436 Youden index J. Lactate/Albumin ratio (AUC=0.751) is the most accurate parameter than lactate, albumin and RDW. Lactate, albumin, lactate/albumin ratio and RDW represented independent significant predictors for septic and septic shock mortality.Conclusions: In sepsis and septic shock, lactate and albumin, lactate/albumin ratio, and RDW represented independent significant predictors for mortality. However, the lactate/albumin ratio is the most accurate parameter than lactate, albumin, and RDW.