Association Between Lactate-to-Albumin Ratio and 30-Day All-Cause Mortality in Patients With Traumatic Brain Injury: A MIMIC-IV Study

Background:Traumatic brain injury (TBI) is a major public health concern due to its high mortality and disability rates.In recent years, an increasing number of studies have investigated the association between the lactate-to-albumin ratio (LAR) and clinical outcomes. Material/Methods:This study included 693 patients with TBI from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.Multivariable Cox proportional hazards regression models, Kaplan-Meier curves, and restricted cubic splines were used for statistical analyses. Results:The 30-day all-cause hospital and intensive care unit (ICU) mortality rates among patients with TBI were 19.48% and 19.62%, respectively.Patients with higher LAR values had higher 30-day hospital mortality (14.29% vs 17.32% vs 26.84%, P = 0.002) and 30-day ICU mortality (14.29% vs 17.75% vs 26.84%, P = 0.002).Multivariable Cox regression analysis revealed that a higher LAR was independently associated with an increased risk of 30day hospital mortality (adjusted hazard ratio [HR] = 1.315; 95% confidence interval [CI]: 1.195-1.446;P < 0.001) and 30-day ICU mortality (adjusted HR = 1.303; 95% CI: 1.184-1.434;P < 0.001), even after adjustment for major confounding factors.Restricted cubic spline analysis revealed nonlinear associations of LAR with 30-day allcause hospital and ICU mortality. Conclusions:First-day LAR was independently associated with 30-day all-cause hospital and ICU mortality among patients with TBI who were admitted to the ICU.These findings suggest that LAR may be a potential prognostic marker.