Utilisation of the Lactate/Albumin Ratio as a Mortality Predictor in Patients with Acute Heart Failure in the...

To evaluate the effectiveness of the lactate/serum albumin (L/A) ratio in predicting 30- and 90-day all-cause mortality and 30-day all-cause readmissions in patients presenting to the emergency department (ED) with acute heart failure (AHF).

An observational study. Place and Duration of the Study: Department of Emergency, Kocaeli Derince Training and Research Hospital and Kocaeli City Hospital, Turkiye, from November 2022 to October 2023.

Patients diagnosed with heart failure in the ED were prospectively enrolled. Demographic and clinical data, including serum lactate and albumin levels, were recorded at admission. The L/A ratio was calculated, and its association with 30- and 90-day all-cause mortality and 30-day all-cause hospital readmission was examined. Receiver operating characteristic (ROC) analysis was used to assess its predictive performance.

A total of 410 patients were included. The L/A ratio showed statistical significance for predicting 30-day all-cause mortality but lacked clinical reliability. At a cut-off value of ≥0.85, sensitivity was 66.15%, specificity was 53.04%, and the area under the ROC curve (AUC) was 0.647. At ≥0.61, sensitivity was 56.3%, specificity was 66.32%, and AUC was 0.635. No significant relationship was found between the L/A ratio and 30-day all-cause readmissions. In multivariable logistic regression analysis, the L/A ratio remained independently associated with 30-day all-cause mortality (OR: 2.48, 95% CI: 1.33-4.60, p = 0.004).

The L/A ratio was not a clinically reliable predictor of 30- and 90-day all-cause mortality or 30-day all-cause readmissions among patients presenting to the ED with AHF.

Emergency department, Heart failure, Lactate, Albumin, Mortality.