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Mortality

Elevated Lactate to Albumin Ratio Predicts Mortality in Heart Failure Patients Complicated by Sepsis

Strategic Insights

— 1 min read

A recent study has found a significant association between elevated lactate to albumin ratio (LAR) and mortality in critically ill patients with heart failure complicated by sepsis. Research conducted by Quanzhou First Hospital Affiliated to Fujian Medical University utilized the Medical Information Mart for Intensive Care (MIMIC-IV) database to analyze data from 4,242 patients. The study found that higher LAR levels were associated with increased 28-day and 365-day all-cause mortality, with a significant interaction observed in hypertensive subgroups.

Key Takeaways:

  • Elevated lactate to albumin ratio (LAR) is a reliable and independent predictor of mortality in critically ill patients with heart failure complicated by sepsis.
  • Higher LAR levels are associated with increased 28-day and 365-day all-cause mortality in this patient population.
  • A significant interaction was observed in hypertensive subgroups, highlighting the need for heightened clinical attention.
  • Patients in the highest LAR quartile (0.97) have a significantly increased risk of death, providing a clinically useful reference for rapid identification of high-risk individuals.
  • The study utilized the MIMIC-IV database to analyze data from 4,242 patients with a mean age of 72.04 years and 57.33% male.
  • Kaplan-Meier analysis and Cox regression analysis confirmed the association between LAR and mortality.
  • Restricted cubic splines (RCS) analysis indicated a linear positive correlation between LAR and mortality.
  • Subgroup and sensitivity analyses were conducted to confirm the robustness of the findings.

Statistics:

  • 4,242 patients were included in the study with a mean age of 72.04 years and 57.33% male.
  • Kaplan-Meier analysis showed a significant difference in 28-day and 365-day all-cause mortality across quartiles of LAR (log-rank 0.97).
  • The hazard ratio (HR) for 28-day mortality was 1.313 (95% CI 1.063-1.622) and 1.310 (95% CI 1.092-1.571) for 365-day mortality.
  • RCS analysis indicated a linear positive correlation between LAR and mortality (for nonlinearity 0.05).

Sources:

  • Association of lactate to albumin ratio with short-term and long-term mortality in critically ill patients with heart failure complicated by sepsis: a retrospective study using the MIMIC-IV database (Frontiers in Cardiovascular Medicine, 2025;12:1636375)
  • Quanzhou First Hospital Affiliated to Fujian Medical University
  • MIMIC-IV database
  • Frontiers Media Sa, Avenue Du Tribunal Federal 34, Lausanne, Ch-1015, Switzerland
  • Ling Wang, Dept. of Cardiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, People's Republic of China

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