Lactate dehydrogenase-to-albumin ratio as a potential prognostic indicator in glucocorticoid-treated severe pneumonia: a multicenter retrospective study with external validation - Summary - 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
To assess the prognostic value of the lactate dehydrogenase-to-albumin ratio (LAR) in predicting mortality in severe pneumonia patients treated with glucocorticoids, highlighting its significance in clinical decision-making.
Key Findings:
High admission LAR (≥10.48) is associated with over twofold increased risk of mortality at 30 days (Adjusted HR 2.54) and 90 days (Adjusted HR 2.44).
Non-linear risk escalation confirmed with a biological threshold of 10.22 (P non-linearity < 0.001).
LAR showed improved predictive discrimination (AUC 0.742) compared to PSI (AUC 0.700) and CURB-65 (AUC 0.654).
Patients with high LAR received lower median cumulative glucocorticoid doses but exhibited more rapid clinical progression, indicating a potential need for adjusted treatment strategies.
Interpretation:
Admission LAR serves as a potential prognostic marker for mortality in severe pneumonia patients on glucocorticoids, indicating a need for optimized early intervention in high-risk patients to improve outcomes.
Limitations:
Retrospective design may introduce selection bias and affect data reliability.
Findings may not be generalizable to all pneumonia patients outside the studied cohorts.
Potential confounding factors not fully accounted for in the analysis.
Conclusion:
LAR is a valuable biochemical marker for risk stratification in severe pneumonia patients treated with glucocorticoids, suggesting a need for tailored therapeutic approaches in those exceeding the identified threshold to enhance patient outcomes.
