Association Between Lactate/Albumin Ratio and Delirium Risk in Critically Ill Patients With Acute Heart Failure: A Retrospective Cohort Study

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2026-04-17 DOI:10.1002/clc.70307

Wenjuan Yan, Yajuan Wang, Qiulan Wen, Pengwei Shi

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Abstract

Background

Delirium is a common and serious complication in critically ill patients, particularly those with acute heart failure (HF). The lactate/albumin ratio (LAR) has emerged as a potential biomarker reflecting metabolic and nutritional status, serving as an indicator for delirium risk. This study aims to investigate the association between LAR and delirium incidence in acute heart failure patients.

Methods

We conducted a retrospective observational cohort analysis using the Medical Information Mart for Intensive Care IV (MIMIC-IV-3.1) database, which includes ICU admissions from 2008 to 2022. A total of 1,695 patients diagnosed with acute heart failure were enrolled. LAR was calculated by dividing serum lactate levels by serum albumin levels. Bivariate analyses assessed the relationship between LAR and delirium, while mediation analysis and propensity score matching controlled for confounding variables.

Results

We found a significant association between elevated LAR values and increased delirium risk. Patients with higher LAR exhibited a markedly higher delirium incidence compared to those with lower levels. Age, body mass index (BMI), and specific comorbidities significantly mediated the relationship between LAR and delirium risk, underscoring the multifactorial nature of delirium development in this population.

Conclusions

Our findings suggest that LAR is a valuable biomarker for predicting delirium risk in critically ill acute heart failure patients. Recognizing at-risk patients may enable timely interventions to mitigate delirium and improve ICU outcomes. Further research is warranted to validate these findings and explore targeted management strategies.

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乳酸/白蛋白比率与危重急性心力衰竭患者谵妄风险的关系：一项回顾性队列研究

背景：谵妄是危重症患者常见且严重的并发症，尤其是急性心力衰竭患者。乳酸/白蛋白比率（LAR）已成为反映代谢和营养状况的潜在生物标志物，可作为谵妄风险的指标。本研究旨在探讨急性心力衰竭患者LAR与谵妄发生率的关系。方法：我们使用重症监护医学信息市场IV （MIMIC-IV-3.1）数据库进行回顾性观察队列分析，该数据库包括2008年至2022年ICU住院患者。共有1695名诊断为急性心力衰竭的患者被纳入研究。用血清乳酸水平除以血清白蛋白水平计算LAR。双变量分析评估LAR和谵妄之间的关系，而中介分析和倾向评分匹配控制混淆变量。结果：我们发现LAR值升高与谵妄风险增加之间存在显著关联。高LAR患者谵妄发生率明显高于低LAR患者。年龄、身体质量指数（BMI）和特定的合并症显著介导了LAR和谵妄风险之间的关系，强调了该人群中谵妄发展的多因素性质。结论：我们的研究结果表明，LAR是预测危重急性心力衰竭患者谵妄风险的有价值的生物标志物。识别高危患者可以及时干预以减轻谵妄并改善ICU预后。需要进一步的研究来验证这些发现并探索有针对性的管理策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.