Lactate-to-albumin ratio: A promising predictor of 28-day all-cause mortality in critically Ill patients with acute ischemic stroke

Sen Zhang; Nan Chen; Liansheng Ma

doi:10.1016/j.jstrokecerebrovasdis.2023.107536

Lactate-to-albumin ratio: A promising predictor of 28-day all-cause mortality in critically Ill patients with acute ischemic stroke

J Stroke Cerebrovasc Dis. 2024 Apr 17;33(6):107536. doi: 10.1016/j.jstrokecerebrovasdis.2023.107536. Online ahead of print.

Authors

Sen Zhang¹, Nan Chen², Liansheng Ma³

Affiliations

¹ Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China.
² Department of General Medicine, Xuanwu Hospital of Capital Medical University, Beijing 100053, China.
³ Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China. Electronic address: zly4200@sina.com.

PMID: 38636322
DOI: 10.1016/j.jstrokecerebrovasdis.2023.107536

Abstract

Introduction: Numerous diseases have been found to be associated with the lactate-to-albumin ratio (LAR), as confirmed by existing research. This study aims to investigate the relationship between LAR within 24 hours of admission and a 28-day mortality rate in patients manifesting ischemic stroke.

Methods: This retrospective cohort study utilized data from the Medical Information Mart for Intensive Care IV (MIMIC-IV, version 2.1) database. We included adult patients with acute ischemic stroke (AIS) who were admitted to the intensive care unit. The primary outcome entailed evaluating the ability of LAR to predict death at 28-day of hospital admission in patients with AIS.

Results: A total of 502 patients with ischemic stroke were enrolled in the study, of which 185 (36.9 %) died within 28 days after hospital admission. We identified a linear association between LAR and mortality risk. Compared with the reference group (first LAR tertile), the 28-day mortality was increased in the highest tertile; the fully adjusted HR value was 1.21 (1.08 to 1.40). the Area Under the Curve (AUC) value for LAR was 58.26 % (95 % CI: 53.05 % - 63.46 %), which was higher than that for arterial blood lactate (AUC = 56.88 %) and serum albumin (AUC = 55.29 %) alone. It was not inferior even when compared to SOFA (AUC = 56.28 %). The final subgroup analysis exhibited no significant interaction of LAR with each subgroup (P for interaction: 0.079 - 0.848).

Conclusion: In our study, LAR emerged as a promising predictor of all-cause mortality in acute ischemic stroke patients within 28 days of admission.

Keywords: Albumin; Intensive care unit; Ischemic stroke; Lactate; Mortality; Prognosis.