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Association between lactate-to-albumin ratio and short-time mortality in patients with acute respiratory distress syndrome
The lactate-to-albumin ratio (LAR) has been confirmed to be an effective prognostic marker in sepsis, heart failure, and acute respiratory failure. However, the relationship between LAR and mortality in patients with acute respiratory distress syndrome (ARDS) remains unclear. We aim to evaluate the...
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| Published in: | Journal of clinical anesthesia 2024-12, Vol.99, p.111632, Article 111632 |
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| creator | Wang, He-Xuan Huang, Xue-Hua Ma, Li-Qing Yang, Zhou-Jing Wang, Hai-Lian Xu, Bo Luo, Meng-Qiang |
| description | The lactate-to-albumin ratio (LAR) has been confirmed to be an effective prognostic marker in sepsis, heart failure, and acute respiratory failure. However, the relationship between LAR and mortality in patients with acute respiratory distress syndrome (ARDS) remains unclear. We aim to evaluate the predictive value of LAR for ARDS patients.
A retrospective cohort study.
Medical Information Mart for Intensive Care IV (v2.2) database.
Patients.
769 patients with acute respiratory distress syndrome(ARDS).
We divided the patients into two subgroups according to the primary study endpoint (28-days all-cause mortality): the 28-day survivors and the 28-day non-survivors.
Multivariate Cox Regression, Receiver Operator Characteristic (ROC) and Kaplan–Meier survival analysis were used to investigate the relationship between LAR and short-time mortality in patients with ARDS.
The 28-day mortality was 38 % in this study. Multivariable Cox regression analysis showed that LAR was an independent predictive factor for 28-day mortality (HR 1.11, 95 %CI: 1.06–1.16, P the cut-off value 0.9055) had a significantly higher 28-day overall mortality rate (P |
| doi_str_mv | 10.1016/j.jclinane.2024.111632 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3110400645</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0952818024002617</els_id><sourcerecordid>3131813093</sourcerecordid><originalsourceid>FETCH-LOGICAL-c273t-1adde4a85671d8162003ddf315c3e9517755816b2ed9bf00233db004962dba913</originalsourceid><addsrcrecordid>eNqFkctOHDEQRa0IFAaSX0CWsmHTg8vul3dBKAlISGxgbbntGuFWtz2x3UHD1-PRQBZsWPl1brnqXkLOga2BQXs5rkczOa89rjnj9RoAWsG_kBX0najqhssjsmKy4VUPPTshpymNjLHyAF_JiZCCt1zKFXm5SikYp7MLng6YnxE9nbTJOmOVQ6WnYZmdp3FPUO0tTU8h5iq7GelcdnpyeUcLsS0E-pzos8tPVJslI42Ytq5IQ9xR61Iu50TTztsYZvxGjjd6Svj9bT0jj79_PVzfVHf3f26vr-4qwzuRK9DWYq37pu3A9tByxoS1GwGNESgb6LqmKdcDRyuHDWNcCDuUSWXL7aAliDNycai7jeHvgimr2SWD01TMC0tSAoDVjLV1U9AfH9AxLNGX7goloAfBpChUe6BMDClF3KhtdLOOOwVM7dNRo3pPR-3TUYd0ivD8rfwyzGj_y97jKMDPA4DFj38Oo0qmmGrQuogmKxvcZ3-8Ame3pWg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3131813093</pqid></control><display><type>article</type><title>Association between lactate-to-albumin ratio and short-time mortality in patients with acute respiratory distress syndrome</title><source>Elsevier</source><creator>Wang, He-Xuan ; Huang, Xue-Hua ; Ma, Li-Qing ; Yang, Zhou-Jing ; Wang, Hai-Lian ; Xu, Bo ; Luo, Meng-Qiang</creator><creatorcontrib>Wang, He-Xuan ; Huang, Xue-Hua ; Ma, Li-Qing ; Yang, Zhou-Jing ; Wang, Hai-Lian ; Xu, Bo ; Luo, Meng-Qiang</creatorcontrib><description>The lactate-to-albumin ratio (LAR) has been confirmed to be an effective prognostic marker in sepsis, heart failure, and acute respiratory failure. However, the relationship between LAR and mortality in patients with acute respiratory distress syndrome (ARDS) remains unclear. We aim to evaluate the predictive value of LAR for ARDS patients.
A retrospective cohort study.
Medical Information Mart for Intensive Care IV (v2.2) database.
Patients.
769 patients with acute respiratory distress syndrome(ARDS).
We divided the patients into two subgroups according to the primary study endpoint (28-days all-cause mortality): the 28-day survivors and the 28-day non-survivors.
Multivariate Cox Regression, Receiver Operator Characteristic (ROC) and Kaplan–Meier survival analysis were used to investigate the relationship between LAR and short-time mortality in patients with ARDS.
The 28-day mortality was 38 % in this study. Multivariable Cox regression analysis showed that LAR was an independent predictive factor for 28-day mortality (HR 1.11, 95 %CI: 1.06–1.16, P < 0.001). The area under curve (AUC) of LAR in the ROC was 70.34 % (95 %CI: 66.53 % - 74.15 %) that provided significantly higher discrimination compared with lactate (AUC = 68.00 %, P = 0.0007) or albumin (AUC = 63.17 %, P = 0.002) alone. LAR was also not inferior to SAPSII with the AUC of 73.44 % (95 %CI: 69.84 % - 77.04 %, P = 0.21). Additionally, Kaplan-Meier survival analysis displayed that ARDS patients with high LAR (> the cut-off value 0.9055) had a significantly higher 28-day overall mortality rate (P < 0.001) and in-hospital mortality rate (P < 0.001). However, patients in high LAR group had shorter length of hospital stay (P < 0.001), which might be caused by higher in-hospital mortality.
We confirmed that there was a positive correlation between LAR and 28-day mortality. This could provide anesthesiologists and critical care physicians with a more convenient tool than SAPSII without being superior for detecting ARDS patients with poor prognosis timely.
•ARDS as a life-threatening disease without specific biomarkers for the prognosis.•LAR confirmed to be positively associated with 28-day mortality of ARDS.•The predictive value of LAR not inferior to SAPSII.</description><identifier>ISSN: 0952-8180</identifier><identifier>ISSN: 1873-4529</identifier><identifier>EISSN: 1873-4529</identifier><identifier>DOI: 10.1016/j.jclinane.2024.111632</identifier><identifier>PMID: 39326299</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>28-day all-cause mortality ; Acute respiratory distress syndrome ; Aged ; Biomarkers - blood ; Chronic illnesses ; Chronic obstructive pulmonary disease ; Ethnicity ; Female ; Health risks ; Heart failure ; Hospital Mortality ; Humans ; Intensive care ; Kaplan-Meier Estimate ; Kidney diseases ; Lactate-to-albumin ratio ; Lactic Acid - blood ; Male ; Medical prognosis ; Middle Aged ; Mortality ; Normal distribution ; Physiology ; Pneumonia ; Predictive Value of Tests ; Prognosis ; Regression analysis ; Respiratory distress syndrome ; Respiratory Distress Syndrome - blood ; Respiratory Distress Syndrome - diagnosis ; Respiratory Distress Syndrome - mortality ; Retrospective Studies ; ROC Curve ; Sepsis ; Serum Albumin - analysis ; Statistical analysis ; Steroids ; Trauma ; Variables ; Ventilators ; Vital signs</subject><ispartof>Journal of clinical anesthesia, 2024-12, Vol.99, p.111632, Article 111632</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><rights>2024. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c273t-1adde4a85671d8162003ddf315c3e9517755816b2ed9bf00233db004962dba913</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39326299$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, He-Xuan</creatorcontrib><creatorcontrib>Huang, Xue-Hua</creatorcontrib><creatorcontrib>Ma, Li-Qing</creatorcontrib><creatorcontrib>Yang, Zhou-Jing</creatorcontrib><creatorcontrib>Wang, Hai-Lian</creatorcontrib><creatorcontrib>Xu, Bo</creatorcontrib><creatorcontrib>Luo, Meng-Qiang</creatorcontrib><title>Association between lactate-to-albumin ratio and short-time mortality in patients with acute respiratory distress syndrome</title><title>Journal of clinical anesthesia</title><addtitle>J Clin Anesth</addtitle><description>The lactate-to-albumin ratio (LAR) has been confirmed to be an effective prognostic marker in sepsis, heart failure, and acute respiratory failure. However, the relationship between LAR and mortality in patients with acute respiratory distress syndrome (ARDS) remains unclear. We aim to evaluate the predictive value of LAR for ARDS patients.
A retrospective cohort study.
Medical Information Mart for Intensive Care IV (v2.2) database.
Patients.
769 patients with acute respiratory distress syndrome(ARDS).
We divided the patients into two subgroups according to the primary study endpoint (28-days all-cause mortality): the 28-day survivors and the 28-day non-survivors.
Multivariate Cox Regression, Receiver Operator Characteristic (ROC) and Kaplan–Meier survival analysis were used to investigate the relationship between LAR and short-time mortality in patients with ARDS.
The 28-day mortality was 38 % in this study. Multivariable Cox regression analysis showed that LAR was an independent predictive factor for 28-day mortality (HR 1.11, 95 %CI: 1.06–1.16, P < 0.001). The area under curve (AUC) of LAR in the ROC was 70.34 % (95 %CI: 66.53 % - 74.15 %) that provided significantly higher discrimination compared with lactate (AUC = 68.00 %, P = 0.0007) or albumin (AUC = 63.17 %, P = 0.002) alone. LAR was also not inferior to SAPSII with the AUC of 73.44 % (95 %CI: 69.84 % - 77.04 %, P = 0.21). Additionally, Kaplan-Meier survival analysis displayed that ARDS patients with high LAR (> the cut-off value 0.9055) had a significantly higher 28-day overall mortality rate (P < 0.001) and in-hospital mortality rate (P < 0.001). However, patients in high LAR group had shorter length of hospital stay (P < 0.001), which might be caused by higher in-hospital mortality.
We confirmed that there was a positive correlation between LAR and 28-day mortality. This could provide anesthesiologists and critical care physicians with a more convenient tool than SAPSII without being superior for detecting ARDS patients with poor prognosis timely.
•ARDS as a life-threatening disease without specific biomarkers for the prognosis.•LAR confirmed to be positively associated with 28-day mortality of ARDS.•The predictive value of LAR not inferior to SAPSII.</description><subject>28-day all-cause mortality</subject><subject>Acute respiratory distress syndrome</subject><subject>Aged</subject><subject>Biomarkers - blood</subject><subject>Chronic illnesses</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Health risks</subject><subject>Heart failure</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Kaplan-Meier Estimate</subject><subject>Kidney diseases</subject><subject>Lactate-to-albumin ratio</subject><subject>Lactic Acid - blood</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Normal distribution</subject><subject>Physiology</subject><subject>Pneumonia</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Regression analysis</subject><subject>Respiratory distress syndrome</subject><subject>Respiratory Distress Syndrome - blood</subject><subject>Respiratory Distress Syndrome - diagnosis</subject><subject>Respiratory Distress Syndrome - mortality</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Sepsis</subject><subject>Serum Albumin - analysis</subject><subject>Statistical analysis</subject><subject>Steroids</subject><subject>Trauma</subject><subject>Variables</subject><subject>Ventilators</subject><subject>Vital signs</subject><issn>0952-8180</issn><issn>1873-4529</issn><issn>1873-4529</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkctOHDEQRa0IFAaSX0CWsmHTg8vul3dBKAlISGxgbbntGuFWtz2x3UHD1-PRQBZsWPl1brnqXkLOga2BQXs5rkczOa89rjnj9RoAWsG_kBX0najqhssjsmKy4VUPPTshpymNjLHyAF_JiZCCt1zKFXm5SikYp7MLng6YnxE9nbTJOmOVQ6WnYZmdp3FPUO0tTU8h5iq7GelcdnpyeUcLsS0E-pzos8tPVJslI42Ytq5IQ9xR61Iu50TTztsYZvxGjjd6Svj9bT0jj79_PVzfVHf3f26vr-4qwzuRK9DWYq37pu3A9tByxoS1GwGNESgb6LqmKdcDRyuHDWNcCDuUSWXL7aAliDNycai7jeHvgimr2SWD01TMC0tSAoDVjLV1U9AfH9AxLNGX7goloAfBpChUe6BMDClF3KhtdLOOOwVM7dNRo3pPR-3TUYd0ivD8rfwyzGj_y97jKMDPA4DFj38Oo0qmmGrQuogmKxvcZ3-8Ame3pWg</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Wang, He-Xuan</creator><creator>Huang, Xue-Hua</creator><creator>Ma, Li-Qing</creator><creator>Yang, Zhou-Jing</creator><creator>Wang, Hai-Lian</creator><creator>Xu, Bo</creator><creator>Luo, Meng-Qiang</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>202412</creationdate><title>Association between lactate-to-albumin ratio and short-time mortality in patients with acute respiratory distress syndrome</title><author>Wang, He-Xuan ; Huang, Xue-Hua ; Ma, Li-Qing ; Yang, Zhou-Jing ; Wang, Hai-Lian ; Xu, Bo ; Luo, Meng-Qiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c273t-1adde4a85671d8162003ddf315c3e9517755816b2ed9bf00233db004962dba913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>28-day all-cause mortality</topic><topic>Acute respiratory distress syndrome</topic><topic>Aged</topic><topic>Biomarkers - blood</topic><topic>Chronic illnesses</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Health risks</topic><topic>Heart failure</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Intensive care</topic><topic>Kaplan-Meier Estimate</topic><topic>Kidney diseases</topic><topic>Lactate-to-albumin ratio</topic><topic>Lactic Acid - blood</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Normal distribution</topic><topic>Physiology</topic><topic>Pneumonia</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Regression analysis</topic><topic>Respiratory distress syndrome</topic><topic>Respiratory Distress Syndrome - blood</topic><topic>Respiratory Distress Syndrome - diagnosis</topic><topic>Respiratory Distress Syndrome - mortality</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Sepsis</topic><topic>Serum Albumin - analysis</topic><topic>Statistical analysis</topic><topic>Steroids</topic><topic>Trauma</topic><topic>Variables</topic><topic>Ventilators</topic><topic>Vital signs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, He-Xuan</creatorcontrib><creatorcontrib>Huang, Xue-Hua</creatorcontrib><creatorcontrib>Ma, Li-Qing</creatorcontrib><creatorcontrib>Yang, Zhou-Jing</creatorcontrib><creatorcontrib>Wang, Hai-Lian</creatorcontrib><creatorcontrib>Xu, Bo</creatorcontrib><creatorcontrib>Luo, Meng-Qiang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, He-Xuan</au><au>Huang, Xue-Hua</au><au>Ma, Li-Qing</au><au>Yang, Zhou-Jing</au><au>Wang, Hai-Lian</au><au>Xu, Bo</au><au>Luo, Meng-Qiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between lactate-to-albumin ratio and short-time mortality in patients with acute respiratory distress syndrome</atitle><jtitle>Journal of clinical anesthesia</jtitle><addtitle>J Clin Anesth</addtitle><date>2024-12</date><risdate>2024</risdate><volume>99</volume><spage>111632</spage><pages>111632-</pages><artnum>111632</artnum><issn>0952-8180</issn><issn>1873-4529</issn><eissn>1873-4529</eissn><abstract>The lactate-to-albumin ratio (LAR) has been confirmed to be an effective prognostic marker in sepsis, heart failure, and acute respiratory failure. However, the relationship between LAR and mortality in patients with acute respiratory distress syndrome (ARDS) remains unclear. We aim to evaluate the predictive value of LAR for ARDS patients.
A retrospective cohort study.
Medical Information Mart for Intensive Care IV (v2.2) database.
Patients.
769 patients with acute respiratory distress syndrome(ARDS).
We divided the patients into two subgroups according to the primary study endpoint (28-days all-cause mortality): the 28-day survivors and the 28-day non-survivors.
Multivariate Cox Regression, Receiver Operator Characteristic (ROC) and Kaplan–Meier survival analysis were used to investigate the relationship between LAR and short-time mortality in patients with ARDS.
The 28-day mortality was 38 % in this study. Multivariable Cox regression analysis showed that LAR was an independent predictive factor for 28-day mortality (HR 1.11, 95 %CI: 1.06–1.16, P < 0.001). The area under curve (AUC) of LAR in the ROC was 70.34 % (95 %CI: 66.53 % - 74.15 %) that provided significantly higher discrimination compared with lactate (AUC = 68.00 %, P = 0.0007) or albumin (AUC = 63.17 %, P = 0.002) alone. LAR was also not inferior to SAPSII with the AUC of 73.44 % (95 %CI: 69.84 % - 77.04 %, P = 0.21). Additionally, Kaplan-Meier survival analysis displayed that ARDS patients with high LAR (> the cut-off value 0.9055) had a significantly higher 28-day overall mortality rate (P < 0.001) and in-hospital mortality rate (P < 0.001). However, patients in high LAR group had shorter length of hospital stay (P < 0.001), which might be caused by higher in-hospital mortality.
We confirmed that there was a positive correlation between LAR and 28-day mortality. This could provide anesthesiologists and critical care physicians with a more convenient tool than SAPSII without being superior for detecting ARDS patients with poor prognosis timely.
•ARDS as a life-threatening disease without specific biomarkers for the prognosis.•LAR confirmed to be positively associated with 28-day mortality of ARDS.•The predictive value of LAR not inferior to SAPSII.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39326299</pmid><doi>10.1016/j.jclinane.2024.111632</doi></addata></record> |
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| subjects | 28-day all-cause mortality Acute respiratory distress syndrome Aged Biomarkers - blood Chronic illnesses Chronic obstructive pulmonary disease Ethnicity Female Health risks Heart failure Hospital Mortality Humans Intensive care Kaplan-Meier Estimate Kidney diseases Lactate-to-albumin ratio Lactic Acid - blood Male Medical prognosis Middle Aged Mortality Normal distribution Physiology Pneumonia Predictive Value of Tests Prognosis Regression analysis Respiratory distress syndrome Respiratory Distress Syndrome - blood Respiratory Distress Syndrome - diagnosis Respiratory Distress Syndrome - mortality Retrospective Studies ROC Curve Sepsis Serum Albumin - analysis Statistical analysis Steroids Trauma Variables Ventilators Vital signs |
| title | Association between lactate-to-albumin ratio and short-time mortality in patients with acute respiratory distress syndrome |
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