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Archivos de Medicina de Urgencia de México

2026, Number 1

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Arch Med Urg Mex 2026; 18 (1)

Lactate-albumin index and hospital mortality

Torres-Macotela M, Leal-Águila M, Vergara-Martínez MF

Language: Spanish
References: 36
Page: 32-36
PDF size: 276.42 Kb.


ABSTRACT

Background: decompensated chronic liver disease and upper gastrointestinal bleeding are associated with substantial morbidity and mortality. The lactate-albumin index has been proposed as a simple risk-stratification tool in critical illness, but its performance in this setting remains uncertain.
Objective: to determine the performance of the lactate-albumin index for in-hospital mortality in patients with decompensated chronic liver disease and upper gastrointestinal bleeding.
Methods: prospective, observational, analytical, single-center study. Adults with decompensated chronic liver disease and upper gastrointestinal bleeding were included. The predefined cutoff of › 1.7 was assessed, and sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios, and area under the ROC curve were estimated. The relationship with mortality was explored with the Phi coefficient. A p value ‹ 0.05 was considered significant.
Results: a total of 125 patients were included. In-hospital mortality was 50.4% (63/125). The lactate-albumin index was › 1.7 in 56.8% (71/125) of the sample. Among non-survivors, 61.9% had an index › 1.7. For in-hospital mortality, the index showed 61.9% sensitivity, 48.4% specificity, 54.9% positive predictive value, and 55.6% negative predictive value; the positive likelihood ratio was 1.20 and the negative likelihood ratio was 0.79. The area under the ROC curve was 0.449 (95% CI: 0.347-0.550). No statistically significant association between the cutoff and mortality was observed (Phi; p = 0.245).
Conclusion: in this sample, a lactate-albumin index › 1.7 was frequent among non-survivors, but its discriminative capacity for in-hospital mortality was low. Therefore, it should not be considered an independent predictor or a stand-alone decision-making tool; its potential use should be complementary to comprehensive clinical assessment and validated prognostic scores.


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