Lactate/albumin ratio as a prognostic biomarker for in-hospital mortality in pediatric patients with necrotizing enterocolitis.

Abstract

Objective: To assess the lactate/albumin ratio (L/A) as a prognostic biomarker for differentiating in-hospital mortality risk in pediatric patients with necrotizing enterocolitis (NEC).

Methods: We performed a retrospective study utilizing the Pediatric Intensive Care (PIC) database. Patients diagnosed with NEC were categorized into a discharge group and a death group based on in-hospital outcomes. The association between L/A and in-hospital mortality was assessed using logistic regression models.

Results: After inclusion and exclusion criteria, 100 NEC patients were included in the study, with 87 survivors and 13 deaths. The mean age at admission was 21.6 ± 2.4 days, and the mean weight was 2.1 ± 0.1 kg. Significant differences in creatinine, international normalized ratio (INR) and L/A were observed between the groups (p < 0.05). The L/A ratio was a substantial predictor of in-hospital mortality, with an odds ratio (OR) of 5.24 (95% CI: 1.51-18.20, p = 0.01). An L/A cutoff value of 0.56 demonstrated a sensitivity of 0.923 and specificity of 0.486, with an AUC of 0.725 from the ROC curve analysis. Patients with an L/A ratio of ≥ 0.56 had a higher risk of in-hospital mortality (OR = 11.35, 95% CI: 1.40-91.93, p = 0.02).

Conclusion: Our study suggested that the L/A ratio may serve as a reliable prognostic indicator for in-hospital mortality in NEC. However, given the limitations of our research, more prospective studies are still needed in the future to test the predictive value of L/A ratio for the prognosis of NEC disease.

Clinical trial number: Not applicable.