Correlation between Lactate Dehydrogenase to Albumin Ratio and the Prognosis of Patients with Cardiac Arrest

Background: Cardiac arrest (CA) is a common event in the intensive care unit (ICU), which seriously threatens the prognosis of patients. Therefore, it is crucial to determine a simple and effective clinical indicator to judge the prognosis of patients after a CA for later treatments. The purpose of...

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Main Authors: Lili Ye, Jianhong Lu, Meng Yuan, Jie Min, Lei Zhong, Junfei Xu
Format: Article
Language:English
Published: IMR Press 2024-02-01
Series:Reviews in Cardiovascular Medicine
Subjects:
Online Access:https://www.imrpress.com/journal/RCM/25/2/10.31083/j.rcm2502065
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author Lili Ye
Jianhong Lu
Meng Yuan
Jie Min
Lei Zhong
Junfei Xu
author_facet Lili Ye
Jianhong Lu
Meng Yuan
Jie Min
Lei Zhong
Junfei Xu
author_sort Lili Ye
collection DOAJ
description Background: Cardiac arrest (CA) is a common event in the intensive care unit (ICU), which seriously threatens the prognosis of patients. Therefore, it is crucial to determine a simple and effective clinical indicator to judge the prognosis of patients after a CA for later treatments. The purpose of this study was to investigate the relationship between the lactate dehydrogenase to albumin ratio (LAR) and the prognosis of patients after a CA. Methods: The clinical data of participants was obtained from the Medical Information Mart for Intensive Care IV (MIMIC-IV, v2.0; 2008 to 2019). According to the 30-day prognosis, patients were divided into a survivors group (n = 216) and a non-survivors group (n = 304). The optimal LAR threshold was determined using restricted cubic spline (RCS), which divided patients into a high LAR group (≥15.50, n = 257) and a low LAR group (<15.50, n = 263). The ICU hospitalization and 30-day accumulative survival curves of the two groups were plotted following the Kaplan–Meier survival analysis. Multivariate Cox regression was used to analyze the relationship between the LAR and the prognosis of CA patients. Receiver operating characteristic (ROC) curves were drawn to evaluate the predictive efficacy of the LAR on 30-day all-cause mortality, and sensitivity analysis was used to check the reliability of the findings. Results: A total of 520 patients with CA were enrolled and the 30-day mortality was 58.46%. The LAR in the non-survivors group was higher than in the survivors group. The RCS showed a linear trend relationship between the LAR and the mortality risk in patients during their ICU stay and 30 days; moreover, as the LAR increased, so did the risk of mortality. The Kaplan–Meier survival curve showed that compared with the low LAR group, the cumulative survival rates of ICU hospitalization and 30 days were lower in the high LAR group among CA patients (p < 0.001). Multivariate Cox regression analysis showed that an elevated LAR (≥15.50) was an independent risk factor for mortality during ICU stay and 30 days (p < 0.005). ROC analysis suggested that the LAR was superior to the sequential organ failure assessment (SOFA) score in predicting the 30-day all-cause mortality in CA patients (area under the curve (AUC) = 0.676, 95% confidence interval [CI]: 0.629–0.723). To verify the reliability of our findings, we performed sensitivity analyses and found that the findings were reliable. Conclusions: An elevated LAR might be a predictor of mortality in patients following a CA during ICU hospitalization and 30 days, thereby it can be used to provide a reference for the clinical management of these patients.
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spelling doaj.art-fe3a831cd4eb4c7789bb9bf905973d0b2024-02-29T06:14:30ZengIMR PressReviews in Cardiovascular Medicine1530-65502024-02-012526510.31083/j.rcm2502065S1530-6550(23)01186-9Correlation between Lactate Dehydrogenase to Albumin Ratio and the Prognosis of Patients with Cardiac ArrestLili Ye0Jianhong Lu1Meng Yuan2Jie Min3Lei Zhong4Junfei Xu5Department of Intensive Care Unit, Huzhou Central Hospital, Affiliated Huzhou Hospital of Zhejiang University School of Medicine, 313000 Huzhou, Zhejiang, ChinaDepartment of Intensive Care Unit, Huzhou Central Hospital, Affiliated Huzhou Hospital of Zhejiang University School of Medicine, 313000 Huzhou, Zhejiang, ChinaDepartment of Intensive Care Unit, Huzhou Central Hospital, Affiliated Huzhou Hospital of Zhejiang University School of Medicine, 313000 Huzhou, Zhejiang, ChinaDepartment of Intensive Care Unit, Huzhou Central Hospital, Affiliated Huzhou Hospital of Zhejiang University School of Medicine, 313000 Huzhou, Zhejiang, ChinaDepartment of Intensive Care Unit, Huzhou Central Hospital, Affiliated Huzhou Hospital of Zhejiang University School of Medicine, 313000 Huzhou, Zhejiang, ChinaDepartment of Intensive Care Unit, Huzhou Central Hospital, Affiliated Huzhou Hospital of Zhejiang University School of Medicine, 313000 Huzhou, Zhejiang, ChinaBackground: Cardiac arrest (CA) is a common event in the intensive care unit (ICU), which seriously threatens the prognosis of patients. Therefore, it is crucial to determine a simple and effective clinical indicator to judge the prognosis of patients after a CA for later treatments. The purpose of this study was to investigate the relationship between the lactate dehydrogenase to albumin ratio (LAR) and the prognosis of patients after a CA. Methods: The clinical data of participants was obtained from the Medical Information Mart for Intensive Care IV (MIMIC-IV, v2.0; 2008 to 2019). According to the 30-day prognosis, patients were divided into a survivors group (n = 216) and a non-survivors group (n = 304). The optimal LAR threshold was determined using restricted cubic spline (RCS), which divided patients into a high LAR group (≥15.50, n = 257) and a low LAR group (<15.50, n = 263). The ICU hospitalization and 30-day accumulative survival curves of the two groups were plotted following the Kaplan–Meier survival analysis. Multivariate Cox regression was used to analyze the relationship between the LAR and the prognosis of CA patients. Receiver operating characteristic (ROC) curves were drawn to evaluate the predictive efficacy of the LAR on 30-day all-cause mortality, and sensitivity analysis was used to check the reliability of the findings. Results: A total of 520 patients with CA were enrolled and the 30-day mortality was 58.46%. The LAR in the non-survivors group was higher than in the survivors group. The RCS showed a linear trend relationship between the LAR and the mortality risk in patients during their ICU stay and 30 days; moreover, as the LAR increased, so did the risk of mortality. The Kaplan–Meier survival curve showed that compared with the low LAR group, the cumulative survival rates of ICU hospitalization and 30 days were lower in the high LAR group among CA patients (p < 0.001). Multivariate Cox regression analysis showed that an elevated LAR (≥15.50) was an independent risk factor for mortality during ICU stay and 30 days (p < 0.005). ROC analysis suggested that the LAR was superior to the sequential organ failure assessment (SOFA) score in predicting the 30-day all-cause mortality in CA patients (area under the curve (AUC) = 0.676, 95% confidence interval [CI]: 0.629–0.723). To verify the reliability of our findings, we performed sensitivity analyses and found that the findings were reliable. Conclusions: An elevated LAR might be a predictor of mortality in patients following a CA during ICU hospitalization and 30 days, thereby it can be used to provide a reference for the clinical management of these patients.https://www.imrpress.com/journal/RCM/25/2/10.31083/j.rcm2502065lactate dehydrogenase to albumin ratiocardiac arrestclinical researchprognosismimic-iv
spellingShingle Lili Ye
Jianhong Lu
Meng Yuan
Jie Min
Lei Zhong
Junfei Xu
Correlation between Lactate Dehydrogenase to Albumin Ratio and the Prognosis of Patients with Cardiac Arrest
Reviews in Cardiovascular Medicine
lactate dehydrogenase to albumin ratio
cardiac arrest
clinical research
prognosis
mimic-iv
title Correlation between Lactate Dehydrogenase to Albumin Ratio and the Prognosis of Patients with Cardiac Arrest
title_full Correlation between Lactate Dehydrogenase to Albumin Ratio and the Prognosis of Patients with Cardiac Arrest
title_fullStr Correlation between Lactate Dehydrogenase to Albumin Ratio and the Prognosis of Patients with Cardiac Arrest
title_full_unstemmed Correlation between Lactate Dehydrogenase to Albumin Ratio and the Prognosis of Patients with Cardiac Arrest
title_short Correlation between Lactate Dehydrogenase to Albumin Ratio and the Prognosis of Patients with Cardiac Arrest
title_sort correlation between lactate dehydrogenase to albumin ratio and the prognosis of patients with cardiac arrest
topic lactate dehydrogenase to albumin ratio
cardiac arrest
clinical research
prognosis
mimic-iv
url https://www.imrpress.com/journal/RCM/25/2/10.31083/j.rcm2502065
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