Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Qingdao University, Qingdao, Shandong, People's Republic of China.
Medicine (Baltimore). 2023 Sep 29;102(39):e35410. doi: 10.1097/MD.0000000000035410.
We aimed to investigate the association between the lactate/albumin ratio (LAR), and in-hospital mortality in critically ill patients with acute respiratory failure. This retrospective cohort study was conducted based on the medical information mart for intensive care-IV database, which included critically ill adult patients with acute respiratory failure whose primary endpoint was in-hospital death. The analyses included curve fitting, a logistic multivariate regression model, and subgroup analysis. In this study, 6028 intensive care unit patients with acute respiratory failure were analyzed. Of these, 1843 (30.57%) died. After adjusting for confounding factors, a nonlinear relationship between LAR and in-hospital mortality was observed, and the risk of death was found to decrease by 81% with a reduction of 1 unit of LAR when it was < 4.46. The association between LAR and in-hospital mortality was not statistically significant when LAR was > 4.46. Hence, the relationship between LAR and in-hospital mortality could only be observed when the LAR was < 4.46. There is a nonlinear relationship between LAR and the risk of in-hospital death in intensive care unit patients with acute respiratory failure, and there is a saturation effect.
我们旨在探讨乳酸/白蛋白比值（LAR）与急性呼吸衰竭危重症患者住院死亡率之间的关系。这项回顾性队列研究基于重症监护信息集市-IV 数据库进行，其中包括急性呼吸衰竭的成年危重症患者，其主要终点为住院死亡。分析包括曲线拟合、逻辑多元回归模型和亚组分析。本研究分析了 6028 例急性呼吸衰竭的重症监护病房患者。其中，1843 例（30.57%）死亡。在调整混杂因素后，观察到 LAR 与住院死亡率之间存在非线性关系，当 LAR<4.46 时，LAR 降低 1 单位，死亡风险降低 81%。当 LAR>4.46 时，LAR 与住院死亡率之间的关联无统计学意义。因此，只有当 LAR<4.46 时，才能观察到 LAR 与住院死亡率之间的关系。急性呼吸衰竭的重症监护病房患者的 LAR 与住院死亡风险之间存在非线性关系，且存在饱和效应。
