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Association between Lactate-to-Albumin Ratio and 28-day In-Hospital Poor Outcomes in Acute Limb Ischemia: A
Yuan Feng1, Hongfei An1, Mengchao Wu1
1Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Background:
The lactate-to-albumin ratio (LAR) is a novel prognostic marker in conditions such as respiratory failure and sepsis, but its value in acute lower limb ischemia (ALI) remains unclear.
Methods:
ALI patients were retrospectively enrolled from our hospital and the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. LAR was the exposure of interest, and the primary outcome was in-hospital adverse events, defined as death or amputation within 28 days.
Results:
In the inner cohort, 18 patients experienced adverse events and 93 did not. In the MIMIC cohort, 73 had adverse events and 154 served as controls. Multivariable Cox regression in both cohorts showed that higher LAR was independently associated with increased risk of in-hospital adverse events. LAR demonstrated moderate discrimination, with an area under the curve of 0.762 in the inner cohort and 0.647 in the MIMIC cohort. Subgroup analyses found no significant interactions in the inner cohort. In the MIMIC cohort, the association between LAR and adverse events was stronger in patients without atrial fibrillation (hazard ratio [HR] = 1.69) than in those with atrial fibrillation (HR = 1.25).
Conclusions:
LAR was independently associated with in-hospital death or amputation in patients with ALI.