PROGNOSTIC VALUE OF LACTATE-ALBUMIN RATIO AND RENA kchan023@e.ntu.edu.sg

PE020

PROGNOSTIC VALUE OF LACTATE-ALBUMIN RATIO AND RENA

5

 

 

 

 

Singapore

Oral only

Emergency laparotomy (EL) bears high post-operative morbidity and mortality, especially for older and frail patients. Lactate-albumin-ratio (LAR) has been increasingly used in surgical patients to predict post-operative outcomes. However, LAR is affected by renal function. This study aims to evaluate the association between LAR, renal function and 1-year mortality in older patients who underwent EL.

This is a retrospective study on older patients (≥65 years) who underwent EL from Jan 2016-Dec 2022. Patients who underwent EL for trauma or vascular surgery were excluded. The cohort was stratified into three tertiles based on LAR. Cox regression (adjusted for age, sex, ethnicity, Charlson comorbidity index (CCI) ≥4, Clinical frailty scale (CFS) ≥4, malignancy, body mass index and skeletal muscle index) was performed to identify the correlation between LAR and 1-year mortality. Mediation analysis was performed to determine whether renal function mediated the association between LAR and 1-year mortality.

There were 360 patients included in the study. The mean age was 75.3 years. There were 55.4% and 73.9% who had CFS ≥4 and CCI ≥4 respectively. There were 28.1% of patients who underwent EL for underlying malignancy. The overall 1-year mortality was 16.7%. High LAR was an independent predictor of 1-year mortality (adjusted HR 1.94, 95% CI: 1.16-3.24), while lactate alone was not. Mediation analysis revealed that renal function accounted for a significant portion (30.6%) of the association between LAR and mortality.

High LAR was associated with increased 1-year mortality in older patients who underwent EL, with possible mediation by renal function.