Wu Rui, Xing Bo, Zhou Zijun, Huang Yuting, Yu Liming, Wang Huishan
School of Life Sciences and Biopharmaceuticals, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning, People's Republic of China.
State Key Laboratory of Frigid Zone Cardiovascular Disease, Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, 83 Wenhua Road, Shenyang, 110016, Liaoning, People's Republic of China.
Eur J Med Res. 2025 Sep 15;30(1):845. doi: 10.1186/s40001-025-03170-6.
The lactate-to-albumin ratio (LAR) has emerged as a composite biomarker reflecting metabolic stress and nutritional status. This study aimed to evaluate the association between the LAR and 28 day mortality in hypertensive patients with atrial fibrillation (AF).
We conducted a retrospective cohort study using the MIMIC-IV v3.1 database. Patients were screened for inclusion based on predefined criteria, resulting in a final cohort of 1087 eligible patients. Mortality within 28 days of ICU admission was the primary endpoint. Statistical analyses included LASSO regression and multivariate Cox regression, receiver operating characteristic (ROC) curve, and Kaplan‒Meier survival curve analyses.
The overall 28 day mortality rate was 22.8% (n = 248). Compared with survivors, nonsurvivors presented significantly higher LAR values (0.74 vs. 0.52, p < 0.001). Multivariate analyses indicated that the LAR was an independent predictor of 28-day mortality (HR 1.03, 95% CI 1.01-1.06, p < 0.05), even after adjusting for multiple clinical confounders. ROC analysis confirmed that the LAR had superior predictive ability (AUC 0.661) compared with other biomarkers. Kaplan‒Meier survival analysis revealed significant differences in mortality between the high- and low-LAR groups (HR 2.55, 95% CI 1.97-3.30, p < 0.05).
The LAR is an independent predictor of short-term mortality in hypertensive patients with AF. As a practical and easily applicable biomarker, the LAR holds significant potential for early risk stratification and tailored management in this high-risk population. Our findings underscore the importance of integrating LAR into clinical practice to optimize patient outcomes in critical care settings.
乳酸与白蛋白比值（LAR）已成为反映代谢应激和营养状况的复合生物标志物。本研究旨在评估LAR与高血压合并心房颤动（AF）患者28天死亡率之间的关联。
我们使用MIMIC-IV v3.1数据库进行了一项回顾性队列研究。根据预先定义的标准筛选纳入患者，最终队列中有1087例符合条件的患者。ICU入院后28天内的死亡率是主要终点。统计分析包括LASSO回归和多变量Cox回归、受试者工作特征（ROC）曲线以及Kaplan-Meier生存曲线分析。
总体28天死亡率为22.8%（n = 248）。与幸存者相比，非幸存者的LAR值显著更高（0.74对0.52，p < 0.001）。多变量分析表明，即使在调整了多个临床混杂因素后，LAR仍是28天死亡率的独立预测因子（HR 1.03，95%CI 1.01 - 1.06，p < 0.05）。ROC分析证实，与其他生物标志物相比，LAR具有更好的预测能力（AUC 0.661）。Kaplan-Meier生存分析显示，高LAR组和低LAR组之间的死亡率存在显著差异（HR 2.55，95%CI 1.97 - 3.30，p < 0.05）。
LAR是高血压合并AF患者短期死亡率的独立预测因子。作为一种实用且易于应用的生物标志物，LAR在这一高危人群的早期风险分层和个体化管理方面具有巨大潜力。我们的研究结果强调了将LAR纳入临床实践以优化重症监护环境中患者预后的重要性。
