Observational studyBMC pediatrics2026
Lactate-albumin ratio measurements at multiple time points and their association with outcome in pediatric trauma: a PICU-based study.
Observational study in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChildhood trauma is one of the leading global causes of morbidity and mortality. Due to the trauma-triggered systemic inflammatory response, simple laboratory parameters are important for rapid assessment in pediatrics. Lactate is an indicator of hypoxia, serum albumin is a negative acute phase reactant, and the lactate-to-albumin ratio (L/A) has been reported to be associated with trauma severity and mortality. The aim of this study was to evaluate the association between L/A measurements at 0, 24, and 48 h and PICU mortality in pediatric trauma patients. Secondary outcomes were recorded and described but were not included as primary analytical endpoints.
methodsThis retrospective observational cohort study included patients aged 1 month-18 years admitted to a tertiary PICU due to trauma between May 2023 and September 2025. Only cases with complete paired data at 0, 24, and 48 h were analyzed. Demographic and clinical variables, laboratory parameters, clinical scores, and Pediatric Risk of Mortality Score III (PRISM III), Pediatric Trauma Score (PTS), Shock Index (SI), Shock Index, Pediatric Age-Adjusted (SIPA), and Glasgow Coma Scale (GCS) were recorded. Receiver operating characteristic (ROC) analysis assessed the ability of L/A measured at 0, 24, and 48 h, together with comparator measures, to discriminate mortality.
resultsAmong 115 patients, mortality was 11.3%. L/A values at 0, 24, and 48 hours were significantly higher in non-survivors than survivors. ROC analysis showed good discriminatory performance for both lactate and L/A at 24 and 48 hours. Although L/A demonstrated numerically higher area under the curve (AUC) values, no formal statistical comparison between lactate and L/A was performed.
conclusionL/A measurements at 24 and 48 h showed good discriminatory performance and were associated with mortality in pediatric trauma. L/A may serve as a complementary biomarker alongside established clinical scoring systems, although its incremental value over lactate alone remains uncertain.
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