Lactate Dehydrogenase-to-Albumin Ratio Predicts 30-Day and 90-Day Mortality in Glucocorticoid-Treated ICU Patients With Pneumonia: A Secondary Analysis of a Multicenter Cohort - Summary - MDSpire
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Lactate Dehydrogenase-to-Albumin Ratio Predicts 30-Day and 90-Day Mortality in Glucocorticoid-Treated ICU Patients With Pneumonia: A Secondary Analysis of a Multicenter Cohort
To evaluate the prognostic utility of the lactate dehydrogenase-to-albumin ratio (LAR) in predicting 30-day and 90-day mortality in ICU patients with pneumonia receiving glucocorticoid treatment.
Key Findings:
Optimal LAR cutoff for 30-day mortality was 13.39.
High LAR (≥13.39) correlated with significantly higher 30-day (45.8% vs. 12.1%) and 90-day (51.4% vs. 14.3%) mortality.
High LAR remained an independent predictor for 30-day (HR 2.07) and 90-day (HR 1.93) mortality after multivariable adjustment.
Doubly robust estimates in the propensity score matched cohort confirmed findings.
LAR showed good discrimination (AUC ≈0.74) and significant incremental prognostic value when added to the PSI score (NRI 0.299).
Interpretation:
LAR is a simple and readily available biomarker that can enhance early risk stratification and guide management in pneumonia patients undergoing glucocorticoid treatment.
Limitations:
Secondary analysis may have inherent biases.
Findings need validation in larger, independent cohorts.
Conclusion:
Incorporating LAR into clinical assessments may improve risk stratification and management strategies for pneumonia patients on glucocorticoids.
