Department of Emergency, The Second Hospital of Shandong University, Jinan, China.
Department of Intensive Care Unit, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China.
Ren Fail. 2024 Dec;46(1):2350238. doi: 10.1080/0886022X.2024.2350238. Epub 2024 May 9.
To explore the relationship between lactate-to-albumin ratio (LAR) at ICU admission and prognosis in critically ill patients with acute kidney injury (AKI).
A retrospective analysis was conducted. Patients were divided into low (<0.659) LAR and high LAR (≥0.659) groups. Least absolute shrinkage and selection operator regression analysis was conducted to select variables associated with the 30-day prognosis. Cox regression analyses were performed to assess the association between LAR and mortality. Kaplan-Meier curves were plotted to compare cumulative survival rates between high and low LAR groups. Subgroup analysis was employed to assess the stability of the results. ROC curve was used to determine the diagnostic efficacy of LAR on prognosis.
A nonlinear relationship was observed between LAR and the risk of 30-day and 360-day all-cause mortality in AKI patients ( < 0.001). Cox regulation showed that high LAR (≥ 0.659) was an independent risk factor for 30-day and 360-day all-cause mortality in patients with AKI ( < 0.001). The Kaplan-Meier survival curves demonstrated a noteworthy decrease in cumulative survival rates at both 30 and 360 days for the high LAR group in comparison to the low LAR group ( < 0.001). Subgroup analyses demonstrated the stability of the results. ROC curves showed that LAR had a diagnostic advantage when compared with lactate or albumin alone ( < 0.001).
High LAR (≥0.659) at ICU admission was an independent risk factor for both short-term (30-day) and long-term (360-day) all-cause mortality in patients with AKI.
探讨 ICU 入院时乳酸/白蛋白比值（LAR）与急性肾损伤（AKI）危重症患者预后的关系。
回顾性分析。将患者分为低（<0.659）LAR 组和高 LAR（≥0.659）组。采用最小绝对收缩和选择算子回归分析筛选与 30 天预后相关的变量。采用 Cox 回归分析评估 LAR 与死亡率的关系。绘制 Kaplan-Meier 曲线比较高、低 LAR 组的累积生存率。进行亚组分析以评估结果的稳定性。ROC 曲线用于确定 LAR 对预后的诊断效能。
AKI 患者的 LAR 与 30 天和 360 天全因死亡率风险之间呈非线性关系（<0.001）。Cox 回归表明，高 LAR（≥0.659）是 AKI 患者 30 天和 360 天全因死亡率的独立危险因素（<0.001）。Kaplan-Meier 生存曲线表明，高 LAR 组在 30 天和 360 天的累积生存率明显低于低 LAR 组（<0.001）。亚组分析表明结果稳定。ROC 曲线表明，与单独使用乳酸或白蛋白相比，LAR 具有诊断优势（<0.001）。
ICU 入院时高 LAR（≥0.659）是 AKI 患者短期（30 天）和长期（360 天）全因死亡率的独立危险因素。
