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

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.

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.

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.

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.