Evaluation of the Efficacy of Serum Lactate-to-Albumin Ratio as a Prognostic Marker for Sepsis and Its Comparison With the Sequential Organ Failure Assessment (SOFA) Score

Introduction: Sepsis is a condition resulting from an abnormal host response to infection that leads to acute organ dysfunction. Early identification of patients at high risk of adverse outcomes is essential. This study aimed to evaluate the prognostic value of the serum lactate-to-albumin (L/A) ratio for sepsis and compare its performance with the Sequential Organ Failure Assessment (SOFA) score in predicting clinical outcomes. Materials and methods: This prospective observational study was conducted at a tertiary care centre from June 2024 to December 2025 and included 90 adult patients diagnosed with sepsis. Serum lactate, serum albumin, and the SOFA scores were recorded on day one and day three. Patients were followed until discharge or in-hospital death. The primary endpoint was in-hospital mortality, while secondary endpoints included the requirement for mechanical ventilation, the need for vasopressor therapy, and length of hospital stay. Statistical analysis was performed using SPSS Statistics version 26 (IBM Corp., Armonk, NY, USA). Continuous variables were expressed as mean ± standard deviation and compared using the Mann-Whitney U test or the Wilcoxon signed-rank test, while categorical variables were analysed using the chi-square test. Receiver operating characteristic (ROC) curve analysis was performed to evaluate predictive ability. Results: Mortality was seen in 42 (46.7%) patients, with a predominance of those aged 61 to 80 years (41, 45.6%) and of the male gender (55, 61.1%). Non-survivors had significantly higher SOFA scores. While the baseline L/A ratio was not significant (p = 0.625), the day three L/A ratio and its change were significantly higher in non-survivors (p < 0.001). On day three, 33 (36.7%) patients required mechanical ventilation and 40 (44.5%) required vasopressors; higher L/A ratios were significantly associated with these outcomes (p ≤ 0.001). The ROC analysis showed strong predictive ability for SOFA day three (area under the curve (AUC) 0.907) and good performance for L/A day three (AUC 0.813). Conclusion: Serial measurement of the L/A ratio provides meaningful prognostic information comparable to the SOFA score and may serve as a practical risk stratification tool for sepsis.