Lactate/Pyruvate Serum Ratio as a Clinical Prognostic Marker for Severe Septic Patients Evolution

Introduction: Various studies have shown that an increase in the lactate/pyruvate (L/P) ratio is associated with higher mortality. In some patients, despite the development of hyperlactatemia, the L/P ratio remains preserved. We determined the impact of variations in lactate, pyruvate, and the L/P ratio on mortality. Material: and methods We recruited patients above 18 years with sepsis without shock. On admission, we measure lactate, C-reactive protein, lactate, pyruvate. All tests were performed 0, 4, and 8 hours after admission. The SOFA score, APACHE-II, and Shock Index were measured in all participants. All patients had a 30-day follow-up. Results: Eighteen patients in our cohort died, with an overall mortality of 21.6%. The most prevalent post-mortem diagnosis was pneumonia (50%), followed by sepsis of abdominal origin (38.9%), being statistical relevant (p = 0.002). An improvement of at least 30% in the L/P ratio in the next 4 hrs upon arrival at the emergency room confers a protective effect on short term in patients with severe sepsis. Conclusion: The L/P ratio appears to be a good and earlier predictor regarding hyperlactatemia and/or hypopyruvatemia. The evaluation of L/P over time is more important, with its ratio > 25 on 4 hrs posterior to hospital admission as the cut-off point associated with higher mortality.