Dataset Information

The lactate to albumin ratio linked to all-cause mortality in critically ill patients with septic myocardial injury.

ABSTRACT:

Background

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.

Methods

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.

Results

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] P < 0.001) and ICU mortality (HR, 1.46 [95% CI: 1.29-1.65] P < 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.

Conclusions

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.

SUBMITTER: Chen S

PROVIDER: S-EPMC10542581 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

The lactate to albumin ratio linked to all-cause mortality in critically ill patients with septic myocardial injury.

Chen Sheng S Guan Senhong S Yan Zhaohan Z Ouyang Fengshan F Li Shuhuan S Liu Lanyuan L Zhong Jiankai J

Frontiers in cardiovascular medicine 20230913

<h4>Background</h4>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.<h4>Methods</h4>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 ...[more]

PMID: 37790597

Similar Datasets

Project description:Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality worldwide. Early identification of high-risk patients is crucial for timely interventions and improved outcomes. The lactate/albumin ratio (LAR) has been suggest as a significant correlate for assessing the risk of mortality in critically ill patients. This study aimed to utilize the American eICU Collaborative Research Database to explore the association between baseline LAR and all-cause mortality within 28 days in ICU of critically ill patients diagnosed with AMI. We conducted a retrospective cohort study of 989 AMI patients from the eICU Collaborative Research Database. Patients were included based on ICD-9 code 410 and the universal definition of AMI. LAR was calculated as the ratio of baseline lactate to albumin levels within the first 24 h of ICU admission. The outcome was all-cause mortality within 28 days after ICU admission. Multivariable logistic regression models were used to evaluate the independent association between LAR and the risk of death, adjusting for potential confounders including demographics, comorbidities, vital signs, and laboratory parameters. Subgroup analyses and nonlinear modeling were performed to further explore the relationship. Of the 989 AMI patients, 171 (17.3%) died within 28 days after ICU admission. Patients who died had significantly higher LAR compared to survivors (1.66 vs. 0.96, p < 0.001). Multivariable analysis showed that each unit increase in LAR was associated with a 2.15-fold higher risk of all-cause mortality within 28 days after ICU admission (95% CI: 1.64-2.83, p < 0.001). Subgroup analyses confirmed the consistent association across different patient characteristics. Nonlinear modeling revealed a threshold effect, where LAR above 2.15 was no longer significantly associated with mortality. Kaplan-Meier survival analysis demonstrated lower survival probabilities for patients with higher LAR(1.0526-5.8235). The findings suggest that a higher LAR was associated with an increased risk of 28-day all-cause mortality for critically ill patients with AMI after ICU admission.

Project description:It has been demonstrated that lactate/albumin (L/A) ratio is substantially relevant to the prognosis of sepsis, septic shock, and heart failure. However, there is still debate regarding the connection between the L/A ratio and severe acute myocardial infarction (AMI). The aim of this study is to determine the prognostic role of L/A ratio in patients with severe AMI. Our retrospective study extracted data from the Medical Information Mart for Intensive Care III (MIMIC-III) database, included 1,134 patients diagnosed with AMI. Based on the tertiles of L/A ratio, the patients were divided into three groups: Tertile1 (T1) group (L/A ratio<0.4063, n=379), Tertile2 (T2) group (0.4063≤L/A ratio≤0.6667, n =379), and Tertile3 (T3) group (L/A ratio>0.6667, n =376). Uni- and multivariate COX regression model were used to analyze the relationship between L/A ratio and 14-day, 28-day and 90-day all-cause mortality. Meanwhile, the restricted cubic spline (RCS) model was used to evaluate the effect of L/A ratio as a continuous variable. Higher mortality was observed in AMI patients with higher L/A ratio. Multivariate Cox proportional risk model validated the independent association of L/A ratio with 14-day all-cause mortality [hazard ratio (HR) 1.813, 95% confidence interval (CI) 1.041-3.156 (T3 vs T1 group)], 28-day all-cause mortality [HR 1.725, 95% CI 1.035-2.874 (T2 vs T1 group), HR 1.991, 95% CI 1.214-3.266 (T3 vs T1 group)], as well as 90-day all-cause mortality [HR 1.934, 95% CI 1.176-3.183 (T2 vs T1 group), HR 2.307, 95% CI 1.426-3.733 (T3 vs T1 group)]. There was a consistent trend in subgroup analysis. The Kaplan-Meier (K-M) survival curves indicated that patients with L/A ratio>0.6667 had the highest mortality. Even after adjusting the confounding factors, RCS curves revealed a nearly linearity between L/A ratio and 14-day, 28-day and 90-day all-cause mortality. Meanwhile, the areas under the receiver operating characteristic (ROC) curve (AUC) of 14-day, 28-day and 90-day all-cause mortality were 0.730, 0.725 and 0.730, respectively. L/A ratio was significantly associated with 14-day, 28-day and 90-day all-cause mortality in critical patients with AMI. Higher L/A ratio will be considered an independent risk factor for higher mortality in AMI patients.

Project description:AimThe progression of acute kidney injury (AKI) might be associated with systemic inflammation. Our study aims to explore the association and predictive value of the red blood cell distribution width (RDW) to human serum albumin (ALB) ratio (RDW/ALB ratio), an inflammation-related indicator, in the risk of all-cause mortality and renal replacement therapy (RRT) in AKI patients admitted in intensive care units (ICU).MethodsA retrospective cohort study was designed, and data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III). The primary outcome was the risk of all-cause mortality (1-month, 3-month, and 12-month), and the secondary outcome was the risk of RRT. The association between the RDW/ALB ratio and the risk of all-cause mortality and RRT was assessed using the Cox regression analysis, with results shown as hazard ratio (HR) and 95% confidence intervals (CIs). The relationship between the RDW/ALB ratio and crude probability of all-cause mortality or RRT was assessed using restricted cubic splines (RCS). The concordance index (C-index) was used to assess the discrimination of the prediction model.ResultsA total of 13,856 patients were included in our study. In the fully adjusted Cox regression model, we found that a high RDW/ALB ratio was associated with an increased risk of 1-month, 3-month, and 12-month all-cause mortality and RRT (all p < 0.05). Moreover, RCS curves showed the linear relationship between the RDW/ALB ratio and the probability of all-cause mortality and RRT, and the probability was elevated with the increase of the ratio. In addition, the RDW/ALB ratio showed a good predictive performance in the risk of 1-month all-cause mortality, 3-month all-cause mortality, 12-month all-cause mortality, and RRT, with a C-index of 0.728 (95%CI: 0.719-0.737), 0.728 (95%CI: 0.721-0.735), 0.719 (95%CI: 0.713-0.725), and 0.883 (95%CI: 0.876-0.890), respectively.ConclusionThe RDW/ALB ratio performed well to predict the risk of all-cause mortality and RRT in critically ill patients with AKI, indicating that this combined inflammatory indicator might be effective in clinical practice.

Dataset Information

The lactate to albumin ratio linked to all-cause mortality in critically ill patients with septic myocardial injury.

Background

Methods

Results

Conclusions

Publications

The lactate to albumin ratio linked to all-cause mortality in critically ill patients with septic myocardial injury.

Similar Datasets

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