Expert review of hematology · 2026
Association between the lactate dehydrogenase-to-albumin ratio and prognosis in ICU sepsis-induced coagulopathy patients.
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Jin Yufeng, He Dong, Xue Yulong
Аннотация
BACKGROUND: Sepsis-induced coagulopathy (SIC) is a severe complication of sepsis with high mortality. The lactate dehydrogenase-to-albumin ratio (LAR), a composite marker of cell injury and inflammation, is associated with sepsis prognosis, but its role in SIC remains unclear.
RESEARCH DESIGN AND METHODS: Data from 1,500 SIC patients in the Medical Information Mart for Intensive Care database were used. The primary outcome was 30-day all-cause mortality and the secondary outcome was 90-day mortality. Kaplan-Meier curves, Cox regression, restricted cubic splines, and subgroup analyses were used.
RESULTS: Compared with the low-LAR group, medium- and high-LAR groups had higher 30- and 90-day mortality rates (p < 0.001). The fully adjusted Cox model showed positive correlations of ln(LAR) with 30-day (HR = 1.17, 95% CI: 1.03-1.31, p = 0.013) and 90-day mortality rates (HR = 1.17, 95% CI: 1.04-1.30, p = 0.007). The relationship between ln(LAR) and 30-day mortality rate was nonlinear (P-non-linear = 0.007), with an inflection point at 4.57. An interaction was observed for dobutamine therapy (P-interaction = 0.03).
CONCLUSIONS: LAR is associated with poor prognosis in patients with SIC, especially once ln(LAR) surpasses 4.57.
RESEARCH DESIGN AND METHODS: Data from 1,500 SIC patients in the Medical Information Mart for Intensive Care database were used. The primary outcome was 30-day all-cause mortality and the secondary outcome was 90-day mortality. Kaplan-Meier curves, Cox regression, restricted cubic splines, and subgroup analyses were used.
RESULTS: Compared with the low-LAR group, medium- and high-LAR groups had higher 30- and 90-day mortality rates (p < 0.001). The fully adjusted Cox model showed positive correlations of ln(LAR) with 30-day (HR = 1.17, 95% CI: 1.03-1.31, p = 0.013) and 90-day mortality rates (HR = 1.17, 95% CI: 1.04-1.30, p = 0.007). The relationship between ln(LAR) and 30-day mortality rate was nonlinear (P-non-linear = 0.007), with an inflection point at 4.57. An interaction was observed for dobutamine therapy (P-interaction = 0.03).
CONCLUSIONS: LAR is associated with poor prognosis in patients with SIC, especially once ln(LAR) surpasses 4.57.