AT Rajasekhar, Chandrasekar Kulli Thirugnanam, Vignessh Raveekumaran, TM Shiva Ganesh
Infection-associated organ dysfunction or sepsis, was responsible for about 166 million sepsis cases and 21.4 million all-cause sepsis-related deaths globally, representing 31.5% of total global deaths in 2025. Heterogeneous pathophysiology (proinflammatory cytokine storm, microvascular dysfunction, metabolic derangements) makes prognosis difficult. This review assesses how well the LAR predicts clinical outcomes in sepsis and septic shock when compared to the Sequential Organ Failure Assessment (SOFA) score. With a focus on mortality prediction and comparative performance, studies evaluating lactate, albumin, LAR, and SOFA score in adult sepsis populations were considered. Tissue hypoperfusion is reflected in serum lactate, but systemic inflammation and low physiological reserve are indicated by hypoalbuminaemia. By combining these factors, LAR provides better predictive accuracy than any marker by itself. LAR is an independent predictor of 28-day death, with area under the curve values ranging from 0.70 to 0.90, according to many cohort studies. The suggested cut-offs range from 0.96 to 1.5, and higher levels are always linked to greater mortality. The SOFA score is still a reliable method for evaluating organ failure and forecasting results. According to new research, LAR may provide incremental or even better prognostic value in some situations and correlates with SOFA. LAR is an accessible and promising biomarker for early sepsis risk assessment. It may improve prognosis accuracy when combined with the SOFA score. However, prior to widespread clinical use, cut-off standardisation and validation via prospective multicentre trials are required.