Scholarlink

<p>The lactate-to-albumin ratio (LAR), as a composite biomarker of integrated metabolic stress and systemic inflammation, has demonstrated prognostic utility in critical illnesses like sepsis and acute pancreatitis. However, its role in surgical/trauma intensive care unit (SICU/TSICU) patients remains underexplored. This study aimed to investigate the relationship between LAR and mortality in SICU/TSICU patients. A retrospective cohort analysis was conducted using the MIMIC-IV database. Adult SICU/TSICU patients with lactate and albumin measurements within 24&#xa0;h of admission were included. Exclusion criteria were: repeat ICU admissions, ICU stay &lt; 24&#xa0;h, and missing lactate or albumin data. Ultimately, 2,665 patients were categorized into quartiles based on LAR. Multivariable Cox regression, restricted cubic spline (RCS), and Kaplan-Meier analyses were employed to evaluate the relationship between LAR and 28-day and 365-day mortality. Subgroup and sensitivity analyses assessed interactions and robustness. The 28-day mortality and 365-day mortality rates reached 17.94% and 31.26%, respectively. Multivariate Cox proportional hazards analysis revealed that elevated LAR independently predicted higher mortality risks (adjusted HR = 1.26, 95% CI:1.19–1.33 for 28-day; HR = 1.20, 95% CI:1.14–1.26 for 365-day), with a dose-response relationship across quartiles (P for trend &lt; 0.001). RCS analysis showed a nonlinear association between LAR and 28-day mortality (P for nonlinear = 0.032). The 365-day RCS analysis demonstrated a significant overall positive association between LAR and mortality risk (P for overall &lt; 0.001). Subgroup analyses confirmed consistency and robustness. Elevated LAR shows significant association with both short- and long-term mortality in SICU/TSICU patients, suggesting potential utility as a complementary prognostic tool. Further validation is warranted before clinical implementation. </p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Elevated lactate-to-albumin ratio predicts short- and long-term mortality in trauma and surgical intensive care patients: a retrospective MIMIC-IV cohort study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月29日

查看全文
  • Zhiting Song,
  • Hailong Miao,
  • Xianyi Xin,
  • Dapeng Guo,
  • Yanan Deng,
  • Haili Wang,
  • Fang Wang

摘要

The lactate-to-albumin ratio (LAR), as a composite biomarker of integrated metabolic stress and systemic inflammation, has demonstrated prognostic utility in critical illnesses like sepsis and acute pancreatitis. However, its role in surgical/trauma intensive care unit (SICU/TSICU) patients remains underexplored. This study aimed to investigate the relationship between LAR and mortality in SICU/TSICU patients. A retrospective cohort analysis was conducted using the MIMIC-IV database. Adult SICU/TSICU patients with lactate and albumin measurements within 24 h of admission were included. Exclusion criteria were: repeat ICU admissions, ICU stay < 24 h, and missing lactate or albumin data. Ultimately, 2,665 patients were categorized into quartiles based on LAR. Multivariable Cox regression, restricted cubic spline (RCS), and Kaplan-Meier analyses were employed to evaluate the relationship between LAR and 28-day and 365-day mortality. Subgroup and sensitivity analyses assessed interactions and robustness. The 28-day mortality and 365-day mortality rates reached 17.94% and 31.26%, respectively. Multivariate Cox proportional hazards analysis revealed that elevated LAR independently predicted higher mortality risks (adjusted HR = 1.26, 95% CI:1.19–1.33 for 28-day; HR = 1.20, 95% CI:1.14–1.26 for 365-day), with a dose-response relationship across quartiles (P for trend < 0.001). RCS analysis showed a nonlinear association between LAR and 28-day mortality (P for nonlinear = 0.032). The 365-day RCS analysis demonstrated a significant overall positive association between LAR and mortality risk (P for overall < 0.001). Subgroup analyses confirmed consistency and robustness. Elevated LAR shows significant association with both short- and long-term mortality in SICU/TSICU patients, suggesting potential utility as a complementary prognostic tool. Further validation is warranted before clinical implementation.