The association between lactate glucose ratio and 28-day all-cause mortality, shock index, and length of hospital stay in sepsis patient presented to Emergency Department Hospital Canselor Tuanku Muhriz: a prospective observational study

Abstract

Introduction: Sepsis can be associated with high morbidity and mortality if not managed promptly. Both levels of lactate and glucose are found to be deranged in the critically ill with sepsis. Classifying patients according to lactate glucose ratios may aid in the identification of patients with increased mortality in sepsis. This study was done to evaluate the outcome between the lactate glucose ratio (LG ratio) and the 28-days all-cause mortality rate, shock index (SI) and length of hospitalization among patients with sepsis in Malaysia. METHODS: A Single Centre Prospective Observation Study in Emergency Department Universiti Kebangsaan Malaysia was performed. The review included patients aged 18 years and above, who fulfil the definition of sepsis according to Sepsis-3 criteria from May 2021 till April 2023. The outcome included 28-day and in hospital mortality, SI and length stay in hospital, which was traced via electronies health care system and BHT. Glucose and lactate measurement was obtained from venous blood gas result, which was analyzed usi the ABL 800 Basic blood gas analyzer. LG ratio was later calculated and documented. RESULTS: A total of 150 140%) and patients were included in this study [ 60 females (n=40%) and 90 males (n=60%)], with the mean age of 64 years old. LG ratio shows significant values when compared to mortality (p=0.011) and Shock Index (p=0.001). LG ratio has an odds ratio of 2.84 (95% CI 1.27 to 6.37) when compared to mortality, and an odds ratio of 3.47 (95% CI 1.63 to 7.42) when compared to SI. LG ratio is correlated with shock index has a AUROC value, which is 0.66 (95% CI, 0.57–0.75). The LG ratio able to predict 28- days mortality (AUROC value of 0.65; 95% CI, 0.55-0.75). The LG Ratio has a Sp of 84% (95% CI, 74%-90%) with a cut-off of 0.364 in predicting shock, and a Sp of 79% (95% CI, 71%-86%) with a cut-off point of 0.375 in predicting 28-days mortality. There was no significance between LG Ratio and length of hospitalization with a p value of 0.438. CONCLUSION: This study shows patients with lactate glucose ratio ≥0.37 may predict mortality and SI.