Chen Sheng, Guan Senhong, Yan Zhaohan, Ouyang Fengshan, Li Shuhuan, Liu Lanyuan, Zhong Jiankai
Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China.
Department of Rehabilitation Medicine, Shunde Hospital, Southern Medical University, Foshan, China.
Front Cardiovasc Med. 2023 Sep 13;10:1233147. doi: 10.3389/fcvm.2023.1233147. eCollection 2023.
The lactate to albumin ratio (LAR) has emerged as a promising prognostic marker in critically ill patients. Despite its potential utility, the prognostic value of LAR in septic myocardial injury (SMI) remains uncertain.
This study aims to investigate the prognostic significance of LAR in SMI through a retrospective cohort analysis of data from the Medical Information Mart for Intensive Care III (MIMIC-III) (v1.4) database. The study included intensive care unit (ICU)-admitted patients (age ≥18 years) diagnosed with SMI. The primary endpoint was in-hospital mortality.
A total of 704 patients were included in the study, of which 59.10% were male. Hospital mortality and ICU mortality rates were recorded at 29.97% and 22.87%, respectively. After adjusting for confounding factors, multivariate Cox proportional risk analysis demonstrated that LAR was independently associated with an increased risk of both hospital mortality (HR, 1.39 [95% CI: 1.24-1.56] < 0.001) and ICU mortality (HR, 1.46 [95% CI: 1.29-1.65] < 0.001). Furthermore, the generalized additive model (GAM) and restricted cubic spline (RCS) model indicated a linear relationship between LAR and mortality rates in the ICU and hospital.
The LAR may serve as a potential prognostic biomarker in critically ill patients with SMI. High LAR levels are associated with a higher risk of in-hospital mortality and can help identify individuals with high mortality rates. Overall, the findings emphasize the importance of using LAR as a tool for risk stratification and management of critically ill patients with SMI.
乳酸与白蛋白比值（LAR）已成为危重症患者中一种有前景的预后标志物。尽管其具有潜在效用，但LAR在脓毒症性心肌损伤（SMI）中的预后价值仍不确定。
本研究旨在通过对重症监护医学信息数据库III（MIMIC-III）（v1.4）数据进行回顾性队列分析，探讨LAR在SMI中的预后意义。该研究纳入了入住重症监护病房（ICU）且年龄≥18岁、诊断为SMI的患者。主要终点是住院死亡率。
本研究共纳入704例患者，其中59.10%为男性。住院死亡率和ICU死亡率分别为29.97%和22.87%。在调整混杂因素后，多因素Cox比例风险分析表明，LAR与住院死亡率（风险比[HR]，1.39[95%置信区间：1.24-1.56] ＜0.001）和ICU死亡率（HR，1.46[95%置信区间：1.29-1.65] ＜0.001）升高的风险独立相关。此外，广义相加模型（GAM）和限制性立方样条（RCS）模型表明，LAR与ICU和医院的死亡率之间存在线性关系。
LAR可能是危重症SMI患者潜在的预后生物标志物。高LAR水平与更高的住院死亡率风险相关，有助于识别高死亡率个体。总体而言，这些发现强调了将LAR用作危重症SMI患者风险分层和管理工具的重要性。
