Prognostic Value of the Lactate/Albumin Ratio Combined with the APACHE II Score in Patients with Sepsis

Corresponding author: LI Ming, limingjtu@163.com

DOI: 10.12201/bmr.202603.00104

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  Abstract: Objective This study aimed to evaluate the prognostic value of the lactate/albumin ratio (LAR) combined with the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in patients with sepsis. Methods A cohort of 76 sepsis patients admitted to the intensive care unit of Wuxi Traditional Chinese Medicine Hospital from July 2022 to July 2025 were selected. Based on 28-day outcomes, patients were stratified into a non-survival group (n=30) and a survival group (n=46). Spearman correlation analysis was conducted to examine the association between each risk factor and 28-day mortality in patients with sepsis. Independent prognostic factors were identified by multivariate Logistic regression, and the predictive value was assessed via receiver operating characteristic (ROC) curve analysis. Results Among the 76 patients, 30 died within 28 days, accounting for 39.5%. Spearman correlation analysis revealed that age, coronary heart disease, liver injury, Sequential Organ Failure Assessment (SOFA) score, APACHE II score, and LAR were positively correlated with 28-day mortality in patients with sepsis (P < 0.05), while albumin was negatively correlated with 28-day mortality (P < 0.001). Multivariate Logistic regression analysis confirmed the APACHE II score and LAR as independent risk factors for 28-day mortality (P < 0.05). The results of ROC curve analysis showed that the area under the curve (AUC) of LAR and APACHE II score alone in predicting 28-day mortality in patients with sepsis were 0.932 and 0.737, respectively (P < 0.05). The combination of both yielded an AUC of 0.946 (P < 0.05), with a sensitivity of 93.3% and a specificity of 82.6%, demonstrating superior predictive value compared to either indicator alone. Conclusion Both APACHE II score and LAR were identified as independent predictors of 28-day mortality in patients with sepsis, and their combination demonstrated enhanced prognostic value.

  Key words: lactate/albumin ratio; APACHE II score; sepsis; prognosis; risk factors

  Submit time: 23 March 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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