Wang Yaotang, Yu Haixia
Critical care medicine department of Inner Mongolia People's Hospital, Inner Mongolia People's Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region, China.
The Geriatric Medicine Department of the People's Hospital of Inner Mongolia Autonomous Region, Hohhot, Inner Mongolia Autonomous Region, China.
BMC Infect Dis. 2025 Mar 26;25(1):414. doi: 10.1186/s12879-025-10838-1.
Sepsis-Associated Acute Kidney Injury (SA-AKI) has high fatality rates, but clear outcome markers are lacking. The objective of this research was to ascertain the link between lactate-to-albumin ratio (LAR) and mortality in cases of SA-AKI.
We performed a retrospective cohort analysis of 3589 critically ill patients with SA-AKI using the Intensive Care Medical Information Mart IV (MIMIC-IV) database. Patients were categorized into four groups based on the quartiles of LAR. The findings of this study provide baseline data and outcomes regarding in-hospital, 30-day, and 90-day mortality rates for SA-AKI patients in the intensive care unit. We utilized multivariate cox regression analysis to compute the adjusted hazard ratio (HR) and 95% confidence intervals (95% CI). Subgroup analysis and restricted cubic spline curves were employed to further investigate the relationship between LAR and mortality.
This study involved 3589 participants with a mean age of 62.5 years. Patients in the LAR group with a Q4 (LAR ≥ 0.95) were associated with an increased risk of in-hospital mortality, 30-day mortality, and 90-day mortality (hazards ratio (HR): 2.11, 95% CI:1.7-2.62; HR: 1.9, 95% CI: 1.55-2.34; HR: 1.91, 95% CI: 1.58-2.31, respectively). Notably, within the subgroup of patients with AKI stages 2 and no CHF patients, the association between LAR and mortality was more pronounced.
The research underscores that elevated LAR are linked to heightened mortality risks. Notably, subgroup analyses have demonstrated that the correlation between LAR and mortality is particularly robust in certain patient cohorts, most notably those with stage 2 AKI and those without congestive heart failure (CHF).
Not applicable.
脓毒症相关性急性肾损伤（SA-AKI）死亡率高，但缺乏明确的预后标志物。本研究的目的是确定SA-AKI患者中乳酸与白蛋白比值（LAR）与死亡率之间的联系。
我们使用重症监护医学信息集市IV（MIMIC-IV）数据库对3589例SA-AKI危重症患者进行了回顾性队列分析。根据LAR的四分位数将患者分为四组。本研究结果提供了重症监护病房中SA-AKI患者的住院、30天和90天死亡率的基线数据和预后情况。我们采用多变量cox回归分析来计算调整后的风险比（HR）和95%置信区间（95%CI）。采用亚组分析和限制性立方样条曲线进一步研究LAR与死亡率之间的关系。
本研究纳入3589名参与者，平均年龄62.5岁。LAR处于Q4（LAR≥0.95）组的患者住院死亡率、30天死亡率和90天死亡率风险增加（风险比（HR）分别为：2.11，95%CI：1.7-2.62；HR：1.9，95%CI：1.55-2.34；HR：1.91，95%CI：1.58-2.31）。值得注意的是，在急性肾损伤2期且无充血性心力衰竭的患者亚组中，LAR与死亡率之间的关联更为明显。
该研究强调LAR升高与更高的死亡风险相关。值得注意的是，亚组分析表明，LAR与死亡率之间的相关性在某些患者队列中尤为显著，最明显的是那些患有2期急性肾损伤和无充血性心力衰竭（CHF）的患者。
不适用。
