Prognostic implications of lactate dehydrogenase-to-albumin ratio in pediatric intensive care unit patients: a single-center prospective study.

OBJECTIVE: To evaluate the lactate dehydrogenase-albumin ratio (LAR) as a mortality predictor in critically ill children. METHODS: This study included 102 patients (aged 1 month to 14 years) admitted to the Pediatric Intensive Care Unit with critical illness, failure of one or more organ systems, over 6 months after exclusions. Initial labs included complete blood count, C-reactive protein, liver function tests, lactate-dehydrogenase (LDH), and albumin; subsequently, LAR was calculated. LDH, albumin, and LAR were correlated with the pediatric Sequential Organ Failure Assessment (pSOFA) score and mortality. Descriptive statistics, comparative tests, receiver operating characteristic (ROC) curve analysis, and logistic regression were performed. RESULTS: Median age was 2 years, and 56.9% were male. Pulmonary causes were the main admission diagnosis (33.3%). Non-survivors had lower median albumin, higher median LDH and LAR levels, and higher rates of ventilation and inotrope use. The median LAR was higher in patients requiring ventilation and inotropes. LAR positively correlated with the pSOFA score and C-reactive protein levels. Logistic analysis showed LAR as a mortality predictor (AUC=0.82, cut-off 244.48, OR 1.004, 95%CI 1.002-1.006; p=0.001). CONCLUSIONS: In the Pediatric Intensive Care Unit, LAR could be used as a prognostic tool, especially in resource-limited countries, as it is accessible from routine laboratory tests.