Evidence mapPaperPMID 41006566Full record

ArticleScientific reports2025

Lactate-to-albumin ratio as an independent predictor of 28-day ICU mortality in patients with hypertension: a retrospective cohort study.

Kaifeng Han, Guode Li, Xian Wei, Chen Chen, Yujie Lv, Wenbin Wang, Jijiong Yu, Junlin Huang, Zhichao Zhao

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Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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2 · The registry

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Kaifeng Han *Emergency and Critical Care Medicine Department, The Affiliated Yangming Hospital of Ningbo University, Yuyao, 315400, China.
Guode Li *Department of Cardiology, Maoming People's Hospital, Maoming, China.
Xian WeiDepartment of Critical Care Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, 315400, China.
Chen ChenRenji College, Wenzhou Medical University, Wenzhou, 325035, China.
Yujie LvRenji College, Wenzhou Medical University, Wenzhou, 325035, China.
Wenbin WangRenji College, Wenzhou Medical University, Wenzhou, 325035, China.
Jijiong YuDepartment of Emergency, The Affiliated Yangming Hospital of Ningbo University, Yuyao, 315400, China.
Junlin HuangDepartment of Cardiology, Maoming People's Hospital, Maoming, China.
Zhichao ZhaoDepartment of Critical Care Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, 315400, China. 308270048@zcmu.edu.cn.

Funding

The study was censored and approved by the Yuyao Municipal HealthScience and Technology PlanProject (Key Project) 2025YZD02
6 · The paper itself

Abstract

This study aims to explore the association between the lactate-to-albumin ratio (LAR) and the risk of mortality in critically ill patients with hypertension. This is a retrospective cohort study utilizing data from the Medical Information Mart for Intensive Care IV (MIMIC-IV, v3.1) database. Participants were categorized into tertiles based on LAR levels (low: <0.46, intermediate: 0.46-0.81, high: >0.81). The primary outcome was 28-day mortality. Kaplan-Meier curves were used to compare survival probabilities among patients in different LAR tertiles. Multivariable COX proportional hazards regression analysis and restricted cubic spline (RCS) regression were employed to assess the association between LAR levels and mortality in hypertensive patients. Additionally, subgroup and mediation analyses were conducted. A total of 4,504 patients were included in this study. Kaplan-Meier survival curves revealed that hypertensive patients in the highest LAR tertile had the highest mortality rate (log-rank test, P < 0.001). Multivariable COX regression analysis demonstrated that higher LAR levels were independently associated with an increased risk of 28-day mortality (HR: 1.240, 95% CI: 1.138-1.351, P < 0.001). Compared to the lowest LAR tertile, patients in the highest LAR tertile had a significantly increased 28-day mortality risk (HR = 1.229, 95% CI: 1.035-1.459, P = 0.019). In the fully adjusted model (Model 5), the highest LAR tertile was independently associated with a 22.9% increased mortality risk (HR = 1.229, 95% CI: 1.035-1.459, P = 0.019) compared to the lowest tertile. Restricted cubic spline (RCS) regression indicated a non-linear relationship between LAR levels and mortality risk in the unadjusted model (non-linear P-value = 0.026). Subgroup analysis further identified interactions between BMI, antihypertensive therapy, and mortality in hypertensive patients. Finally, mediation analysis suggested that SOFA and SAPS II scores partially mediated the association between LAR and ICU survival time. LAR demonstrates utility as a prognostic marker for 28-day mortality in critically ill hypertensive patients, particularly in those with obesity or untreated hypertension.

Indexed as

HypertensionLactic AcidSerum AlbuminAgedBiomarkersCritical IllnessFemaleHumansIntensive Care UnitsKaplan-Meier EstimateMaleMiddle AgedPrognosisProportional Hazards ModelsRetrospective StudiesRisk FactorsBiomarkersLactic AcidSerum Albumin28-day mortalityHypertensionLactate-to-albumin ratioMIMIC-IV database

Identifiers

PMID41006566
PMCPMC12475135

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.