ID:36 FC-D05-6 Prognostic Value of Lactate-Albumin Ratio in Patients with ARDS Undergoing VV-ECMO

Background: Predicting mortality in acute respiratory distress syndrome (ARDS) patients requiring veno-venous extracorporeal membrane oxygenation (VV-ECMO) remains challenging. We investigated the prognostic value of the lactate-albumin ratio (LAR) compared to traditional scoring systems and other inflammatory markers. Methods: A retrospective study was conducted on 62 ARDS patients treated with VV-ECMO at Pusan National University Hospital (2015–2025). Patients were stratified by 30-day survival and LAR cut-off values. Predictive performance was evaluated using the Area Under the Receiver Operating Characteristic curve (AUROC). Result: Non-survivors (n=23) exhibited higher LAR levels compared to survivors (1.92 vs. 0.80, p<0.001). Multivariate logistic regression identified LAR as an independent predictor of mortality (HR 2.564; 95% CI 1.378–4.773; p=0.003). For 30-day mortality, LAR demonstrated superior predictive power (AUROC 0.813) compared to SOFA (0.711), APACHE II (0.724), CAR (0.634), and PAR (0.595). Patients with LAR >1.355 had higher 30-day (79.2% vs. 10.5%) and 90-day mortality (91.7% vs. 23.7%). Conclusion: LAR is a potent predictor of short- and long-term mortality in ARDS patients undergoing VV-ECMO. Our data suggest that LAR may offer higher predictive accuracy than traditional clinical scores and other ratio-based inflammatory markers.