Comparison between APACHE II score and lactate/albumin ratio in predicting mortality in septic patients

Overview

Abstract

Objective: To compare the Acute Physiological And Chronic Health Evaluation II (APACHE II) scores and lactate/albumin ratio (LAR) in relation to mortality rates among septic patients in intensive care units (ICU).

Design: Retrospective case-control study.

Setting: Research from medical record data at the ICU of Dr. Wahidin Sudirohusodo Hospital in January-December 2023.

Patients and participants: 147 septic patients were collected using the total sampling technique.

Measurements and results: Patients were identified based on 28-day mortality and APACHE II and LAR measurements. APACHE II and LAR were significantly greater in deceased patients than survivors within 28 days of sepsis diagnosis (p<0.05). The area under the receiver operating characteristic (ROC) curve (AUC) of the APACHE II was 0.784 (95% CI=0.704-0.864, p<0.001) with a cut-off of 21.5, sensitivity of 71.6%, and specificity of 75.6%. The AUC of LAR was 0.733 (95% CI=0.651-0.815, p<0.001) with a cut-off of 0.955, sensitivity of 67.6%, and specificity of 68.9%.

Conclusions: The APACHE II and LAR were good predictors of 28-day sepsis mortality, whereas the APACHE II obtained better diagnostic accuracy, sensitivity, and specificity than the LAR.

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June 2025, Volume 28 Number 3

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