The combined use of three widely available biochemical markers as predictor of organ failure in critically ill patients. (17th August 2016)

• Record Type: Journal Article
• Authors: Helliksson, Fredrik; Wernerman, Jan; Wiklund, Lars; Rosell, Jon; Karlsson, Mathias
• Is Part Of: Scandinavian journal of clinical & laboratory investigation. Volume 76:Number 6(2016)
• Page Start: 479
• Page End: 485
• Publication Date: 2016-08-17
• Subjects: Biomarkers -- critical care -- lactate dehydrogenases -- multiple organ failure -- organ dysfunction scores; Clinical biochemistry -- Periodicals; Physiology, Pathological -- Periodicals; Physiology, Experimental -- Periodicals; Medicine -- Research -- Periodicals; Clinical medicine -- Periodicals; 616.0072
• DOI: 10.1080/00365513.2016.1201850
• Languages: English
• ISSNs: 0036-5513

Abstract

Abstract: Background: We hypothesized that lactate dehydrogenase, LDH/albumin ratio in combination with or without magnesium (Mg 2+ ) could predict organ failure in critically ill adult patients. The aim of this study was to describe a new risk index for organ failure or mortality in critically ill patients based on a combination of these routinely available biochemical plasma biomarkers. Methods: Patients ≥ 18 years admitted to the intensive care unit (ICU) were screened. Albumin and LDH were analyzed at the time of admission to ICU ( n = 347). Organ failure assessed with 'Sequential Organ Failure Assessment' (SOFA) score was used, and 30-day mortality was recorded. The predictive value of the test was calculated using the areas under the receiving operating characteristic (ROC) curve. Results: The LDH/albumin ratio was higher in patients who developed organ failure as compared to those who did not ( p < 0.001). The areas under the ROC curve were 0.77 both for prediction of multiple organ failure and for 30-day mortality. In a subgroup of patients ( n = 183) admitted to ICU from the emergency department, the predictive values were 0.86 and 0.80, respectively. Conclusion: The LDH/albumin ratio at ICU admission was associated with the development of multiple organ failure and 30-day mortality in this prospective study. The clinical value of this biomarker as a predictor of organ failure in critically ill patients is yet to be defined.