Lactate dehydrogenase-to-albumin ratio as a potential prognostic indicator in glucocorticoid-treated severe pneumonia: a multicenter retrospective study with external validation - Report - MDSpire
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Lactate dehydrogenase-to-albumin ratio as a potential prognostic indicator in glucocorticoid-treated severe pneumonia: a multicenter retrospective study with external validation
Clinical Report: Evaluating the Lactate Dehydrogenase-to-Albumin Ratio as a Prognostic Marker
Overview
This multicenter study identifies the lactate dehydrogenase-to-albumin ratio (LAR) as a significant prognostic marker for 30-day and 90-day mortality in severe pneumonia patients treated with glucocorticoids. A high admission LAR (≥10.48) is associated with over a twofold increase in mortality risk.
Background
Pneumonia remains a major public health concern, particularly among patients receiving glucocorticoid therapy, which can obscure clinical symptoms and traditional severity assessments. The lactate dehydrogenase-to-albumin ratio (LAR) may provide a more accurate prognostic tool in this context, reflecting the balance between tissue injury and metabolic reserve. Identifying reliable biomarkers is crucial for improving risk stratification and treatment outcomes in this high-risk population.
Data Highlights
{'AUC for LAR 90-Day Mortality': '0.742'}
Key Findings
High admission LAR (≥10.48) significantly predicts increased mortality risk at both 30 and 90 days.
Non-linear risk escalation of mortality was observed with a biological threshold of LAR at 10.22.
LAR demonstrated superior predictive discrimination compared to traditional severity scores (PSI and CURB-65).
Patients with high LAR received lower median glucocorticoid doses, indicating rapid clinical progression.
The findings suggest a need for optimized early intervention in patients exceeding the LAR threshold.
Clinical Implications
The lactate dehydrogenase-to-albumin ratio serves as a valuable prognostic marker in severe pneumonia patients treated with glucocorticoids, aiding in risk stratification. Clinicians should consider LAR in conjunction with traditional assessments to identify high-risk patients who may require more aggressive management.
Conclusion
The admission LAR is a promising, easily accessible biomarker that enhances prognostic accuracy in glucocorticoid-treated pneumonia patients. Its use may facilitate timely interventions for those at elevated risk of mortality.
