Association between the lactate dehydrogenase-to-albumin ratio and prognosis in ICU sepsis-induced coagulopathy patients.

IF 2.8 4区医学 Q2 HEMATOLOGY

Expert Review of Hematology Pub Date : 2026-10-01 Epub Date: 2026-08-10 DOI:10.1080/17474086.2026.2715457

Yufeng Jin, Dong He, Yulong Xue

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引用次数: 0

Abstract

Background: Sepsis-induced coagulopathy (SIC) is a severe complication of sepsis with high mortality. The lactate dehydrogenase-to-albumin ratio (LAR), a composite marker of cell injury and inflammation, is associated with sepsis prognosis, but its role in SIC remains unclear.

Research design and methods: Data from 1,500 SIC patients in the Medical Information Mart for Intensive Care database were used. The primary outcome was 30-day all-cause mortality and the secondary outcome was 90-day mortality. Kaplan-Meier curves, Cox regression, restricted cubic splines, and subgroup analyses were used.

Results: Compared with the low-LAR group, medium- and high-LAR groups had higher 30- and 90-day mortality rates (p < 0.001). The fully adjusted Cox model showed positive correlations of ln(LAR) with 30-day (HR = 1.17, 95% CI: 1.03-1.31, p = 0.013) and 90-day mortality rates (HR = 1.17, 95% CI: 1.04-1.30, p = 0.007). The relationship between ln(LAR) and 30-day mortality rate was nonlinear (P-non-linear = 0.007), with an inflection point at 4.57. An interaction was observed for dobutamine therapy (P-interaction = 0.03).

Conclusions: LAR is associated with poor prognosis in patients with SIC, especially once ln(LAR) surpasses 4.57.

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ICU脓毒症致凝血病患者乳酸脱氢酶与白蛋白比值与预后的关系

背景：脓毒症致凝血病（SIC）是脓毒症的严重并发症，死亡率高。乳酸脱氢酶与白蛋白比（LAR）是细胞损伤和炎症的复合标志物，与脓毒症预后密切相关，但其在SIC中的作用尚不清楚。研究设计与方法：使用重症医学信息集市数据库中1500例SIC患者的数据。主要终点为30天全因死亡率，次要终点为90天死亡率。Kaplan-Meier曲线、Cox回归和受限三次样条用于评估LAR与死亡率之间的关系。亚组分析探讨了研究人群中潜在的效应改变。结果：与低lar组相比，中等和高lar组的30天和90天死亡率（p p = 0.013）和90天死亡率（HR = 1.17, 95% CI: 1.04-1.30, p = 0.007）显著高于低lar组。ln（LAR）与30天死亡率呈非线性关系（p -非线性= 0.007），其拐点为4.57。多巴酚丁胺治疗存在相互作用（p -相互作用= 0.03）。结论：SIC患者LAR与预后不良相关，尤其是ln（LAR）超过4.57时。

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

Expert Review of Hematology HEMATOLOGY-

CiteScore

4.70

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.