Association between the lactate dehydrogenase-to-albumin ratio and prognosis in ICU sepsis-induced coagulopathy patients

BACKGROUND Sepsis-induced coagulopathy (SIC) is a severe complication of sepsis with high mortality. The lactate dehydrogenase-to-albumin ratio (LAR), a composite marker of cell injury and inflammation, is closely associated with sepsis prognosis, but its role in SIC remains unclear.RESEARCH DESIGN AND METHODS Data from 1,500 SIC patients in the Medical Information Mart for Intensive Care database were used. The primary outcome was 30-day all-cause mortality, and the secondary outcome was 90-day mortality. Kaplan-Meier curves, Cox regression, and restricted cubic splines were used to assess the association between LAR and mortality rates. Subgroup analyses explored potential effect modification across study populations.RESULTS Compared with the low-LAR group, medium- and high-LAR groups exhibited significantly higher 30- and 90-day mortality rates (p < 0.001). The fully adjusted Cox model revealed the positive correlations of ln(LAR) with 30-day (HR = 1.17, 95% CI: 1.03–1.31, p = 0.013) and 90-day mortality rates (HR = 1.17, 95% CI: 1.04–1.30, p = 0.007). The relationship between ln(LAR) and 30-day mortality rate was non-linear (P-non-linear = 0.007), with an inflection point at 4.57. An interaction was observed for dobutamine therapy (P-interaction = 0.03).CONCLUSIONS LAR is associated with poor prognosis in patients with SIC, especially once ln(LAR) surpasses 4.57.