Relationship between lactate-to-albumin ratio and 28-day mortality in patients with exacerbation of chronic obstructive pulmonary disease admitted to the Intensive Care Unit

Abstract

Abstract Aim To explore the predictive value of lactate-to-albumin ratio (LAR) on 28-day mortality in patients with exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to the Intensive Care Unit (ICU). Methods According to ICD-9 and ICD-10 diagnosis codes, patients diagnosed with AECOPD in the Medical Information Mart for Intensive Care IV (v.2.2) database were selected. The primary endpoint was 28-day mortality after ICU admission. We used receiver operating characteristic (ROC) curve, Kaplan–Meier (K–M) survival curve, logistic regression analyses and subgroup analysis to assess predictive power of LAR. Results 606 patients were included in this study. The 28-day mortality was 29.7%. The area under the ROC curves (AUC) for LAR were 0.641 [95% confidence interval (CI) 0.592–0.689], which was comparable with OASIS (AUC: 0.662; 95% CI 0.616–0.709; p = 0.471) and SOFA (AUC: 0.660; 95% CI 0.612–0.708; p = 0.500). The cutoff value of LAR was 0.645 by ROC curve. The high-LAR group showed a bad prognosis in K–M analysis (p < 0.001). Multivariate logistic regression shown that LAR was significantly associated with a poor outcome (odds ratio: 1.77; 95% CI 1.16–2.71; p = 0.008). Subgroup analysis showed no significant interaction of LAR with each subgroup (p for interaction: 0.175–0.775). Conclusion LAR is a rational and easily accessible marker, which is remarkably associated with 28-day mortality in ICU patients with AECOPD.

Keywords

• AECOPD
• Lactate to albumin ratio
• 28-day mortality
• Intensive Care Unit