Rasio Laktat/Albumin sebagai Prediktor Mortalitas pada Pasien dengan Sepsis dan Syok Sepsis: Studi Meta-Analisis

F. Baihaqi, Dinda Olinda Delarosa, Rezki Ramadhan
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Abstract

Introduction. The lactate/albumin ratio is an inflammatory biomarker that has been widely used and suggested as a predictor of mortality in patients with sepsis and septic shock. However, the results are inconsistent. This meta-analysis aimed to evaluate the prognostic value of lactate/albumin ratio as a predictor of mortality in patients with sepsis and septic shock. Methods. The study protocol was registered with PROSPERO (CRD42021286242). A literature search was performed using PubMed, Ovid EMBASE, Ovid MEDLINE, SCOPUS, and Web of Sciences to find all studies evaluating the association between lactate/albumin ratio and mortality in patients with sepsis and septic shock. Meta-analysis was performed to synthesize the overall Standardized Mean Difference (SMD) of the lactate/albumin ratio and the pooled Odds Ratio (OR) for mortality with 95% confidence intervals (95% CI). Heterogeneity was assessed using I 2 . Publication bias was assessed quantitatively with Egger’s test. Analysis was performed using Stata version 16. Results. Seven studies (n=10,264 patients) were included in the meta-analysis. The meta-analysis results showed that non-survivor had a higher lactate/albumin ratio than survivor (random-effects model; SMD 1.47; 95% CI 0,91-2,04; p <0.001). Higher lactate/albumin ratio was associated with an increased mortality in sepsis and septic shock patients (fixed-effects model; OR 1.49 (95% CI 1.37-1.62); p <0.001). Conclusions. High lactate/albumin ratio was associated with mortality in sepsis and septic shock patients. Thus, lactate/ albumin ratio can be used as a predictor biomarker in predicting mortality for sepsis and septic shock patients.
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败血症和休克患者的乳酸盐/白蛋白发病率预测比:元分析研究
介绍。乳酸/白蛋白比率是一种炎症生物标志物,已被广泛使用,并被认为是脓毒症和感染性休克患者死亡率的预测指标。然而,结果是不一致的。本荟萃分析旨在评估乳酸/白蛋白比率作为脓毒症和感染性休克患者死亡率预测因子的预后价值。方法。研究方案已在PROSPERO注册(CRD42021286242)。通过PubMed、Ovid EMBASE、Ovid MEDLINE、SCOPUS和Web of Sciences进行文献检索,找到所有评估脓毒症和感染性休克患者乳酸/白蛋白比率与死亡率之间关系的研究。进行meta分析,综合乳酸/白蛋白比率的总体标准化平均差(SMD)和死亡率的合并优势比(OR), 95%置信区间(95% CI)。使用i2评估异质性。用Egger’s检验定量评估发表偏倚。使用Stata version 16进行分析。结果。meta分析包括7项研究(n= 10264例患者)。荟萃分析结果显示,非幸存者的乳酸/白蛋白比率高于幸存者(随机效应模型;SMD 1.47;95% ci为0,91-2,04;p < 0.001)。较高的乳酸/白蛋白比率与脓毒症和感染性休克患者死亡率增加有关(固定效应模型;或1.49 (95% ci 1.37-1.62);p < 0.001)。结论。高乳酸/白蛋白比率与败血症和感染性休克患者的死亡率相关。因此,乳酸/白蛋白比值可作为预测脓毒症和感染性休克患者死亡率的预测指标。
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