Increased lactate dehydrogenase to albumin ratio is associated with short-term mortality in septic ICU patients A retrospective cohort study

Sepsis is well known with high mortality, and there is a need for early recognition of septic patients with poor prognosis. The purpose of this study is to evaluate the association between lactate dehydrogenase to albumin ratio (LAR) and the short-term mortality in sepsis. Septic patients were selected from Medical Information Mart for Intensive Care IV database. The primary and secondary outcomes were 28-day and 90-day all-cause mortality. Cox regression analysis, Kaplan–Meier survival curves, restricted cubic spline and subgroup and sensitivity analyses were performed to explore the relationship between LAR and mortality. The study included 5784 patients with sepsis. Kaplan–Meier analysis showed that patients with higher LAR exhibited lower 28-day and 90-day survival rates. There existed a linear relationship between log2 transformed LAR and 28-day and 90-day mortality. Multivariable Cox regression analysis revealed a positive relationship between log2-LAR and 28-day mortality risk (HR, 1.36; 95% CI, 1.29–1.42; P < .001). Patients in the second and third tertile groups had higher risk for 28-day mortality (HR = 1.46, 95% CI = 1.26–1.70, and HR = 2.14, 95% CI = 1.85–2.49, respectively; P for trend < .001), compared to first tertile group. Similar results were found for 90-day mortality. Subgroup and sensitivity analyses revealed consistent results. High LAR was independently associated with an increased risk of 28-day and 90-day all-cause mortality in patients with sepsis. LAR was suggested to be a promising biomarker for early identification of septic patients at higher risk of short-term mortality.