The lactate-to-albumin ratio (LAR) has shown limited prognostic value for complications among children under five years of age suffering from burn injuries, according to recent research conducted at the Instituto Nacional de Salud del Niño in Lima, Peru. This retrospective study analyzed 258 pediatric patients admitted to the intensive care unit (ICU) for second and/or third-degree burns between 2017 and 2022. The findings indicate not only the challenges of predicting complications based on LAR but also reinforce the necessity of closely monitoring these young patients for signs of deteriorations.
Burn injuries present significant health risks, especially for the pediatric population, where they account for substantial morbidity and mortality. Notably, severe burns often necessitate hospitalization, making it imperative to develop reliable prognostic tools. Previous measures such as the abbreviated burn severity index (ABSI) have been used, but they exhibit limitations, particularly the potential for human error during assessments.
During the study, the researchers measured the LAR by analyzing lactate and albumin levels within the first 48 hours post-burn. The area under the receiver operating characteristic curve (AUC) was utilized to assess the LAR’s ability to predict complications, resulting in an AUC of 0.63 (95% confidence interval 0.54–0.71). This suggests the LAR has limited performance as a standalone prognostic metric.
Interestingly, the study revealed 63 patients (24.4%) developed complications, with sepsis being the most common. Results showed values of LAR above the established threshold were associated with more than double the risk of complications. The adjusted relative risk calculated stood at 2.23 (95% CI 1.51–3.29; p < 0.001), emphasizing the need for careful evaluation of elevated LAR levels.
Despite its inadequate prognostic capabilities compared to other biomarkers, the study highlights the significance of monitoring pediatric burn patients. The findings indicate the potential value of integrating the LAR with other clinical assessments to provide more comprehensive evaluations.
Comparative analysis with other studies gives insight as well; previous research has reported stronger prognostic outcomes measuring lactate or albumin individually. The inconsistency likely stems from various factors, including timing of measurements and patient management methodologies following admission.
Although the LAR did not emerge as the strongest prognostic variant, its correlation with risk increases suggests it may function effectively as one tool among several. Researchers advocate for more extensive future studies to explore optimal measurement times and the combined prognostic capacity of LAR with other indicators.
Growing awareness surrounding the management of pediatric burn patients reaffirms the necessity for rigorous monitoring and the development of effective prognostic tools to address complications proactively. This study serves as the groundwork for enhanced methodologies, illustrating the path for future research aimed at improving care protocols.