ArticleBMC infectious diseases2026
Association of lactate-to-albumin ratio with 28-day mortality in elderly sepsis patients: a retrospective MIMIC-IV database analysis.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe lactate-to-albumin ratio (LAR) is correlated with mortality in critically ill patients; however, its predictive value for sepsis in the elderly remains underexplored.
methodsThis retrospective cohort study used the data from the MIMIC-IV database. The primary outcome was 28-day ICU mortality in elderly patients with sepsis. We used multivariate logistic regression, restricted cubic splines (RCS), subgroup analyses, and machine learning (LightGBM/XGBoost/SVM) to assess the predictive capacity of LAR.
resultsAmong 5,115 eligible patients, elevated log (LAR) independently predicted mortality, as a continuous variable (adjusted odds ratio [OR] = 3.29; 95% confidence interval [CI]: 2.51-4.31; p < 0.001) and in quartiles (Q4 vs. Q1: adjusted OR = 2.11; 95% CI: 1.72-2.59). The RCS indicated a linear LAR-mortality association (p for nonlinear = 0.12). Subgroup analyses confirmed consistency across strata (interaction, p > 0.05). The LightGBM model achieved optimal discriminative performance (area under the curve = 0.788), with log (LAR) as the second-most important feature after the Simplified Acute Physiology Score II.
conclusionLAR is an independent predictor of 28-day mortality in elderly patients with sepsis, despite its limited standalone use. Our LightGBM-based integrative model demonstrated a robust prognostic performance and may aid in clinical decision-making and pending external validation. CLINICAL TRAIL NUMBER: Not applicable.
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