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.