Clinical Report: Enhanced Mortality Prediction Score in ICU Patients with APE

Overview

This study evaluates the lactate-to-albumin ratio (LAR) as a predictor of 28-day mortality in ICU patients with acute pulmonary embolism (APE).

Background

Acute pulmonary embolism (APE) is a critical condition with high mortality rates, particularly in ICU settings. Traditional scoring systems like the simplified Pulmonary Embolism Severity Index (sPESI) often lack predictive accuracy for patients with multi-organ dysfunction. The integration of dynamic indicators such as the lactate-to-albumin ratio (LAR) may enhance risk stratification.

Data Highlights

Key Findings

• LAR showed a linear relationship with 28-day mortality in ICU patients with APE.
• The AUC for LAR was 0.610 in the derivation cohort and improved to 0.710 in the first validation cohort.
• The LAR-sPESI score yielded AUCs of 0.650, 0.733, and 0.701 across the three cohorts.
• Calibration tests indicated acceptable performance for the LAR-sPESI score (P > 0.05 in all cohorts).
• DCA suggested trends within specific probability ranges.
• LAR exhibited moderate discriminative ability for norepinephrine use but limited predictive performance for thrombolysis and mechanical ventilation.

Clinical Implications

The lactate-to-albumin ratio may serve as a predictor of mortality in critically ill patients with APE.

Conclusion

Further validation is warranted to establish the clinical utility of LAR in ICU patients with APE.

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