| Objective:The Lactate-to-Albumin Ratio（LAR）has been applied as a new predictor in sepsis,heart failure and acute respiratory failure.However,the role of LAR in predicting all-cause mortality in patients with acute pancreatitis has not been evaluated.Therefore,this study aimed to elucidate the correlation between LAR and 28-d all-cause mortality in patients with AP.Methods:This study is a retrospective cohort study with study data from the MIMIC-IV（v1.0）database.Adult patients admitted to intensive care units with acute pancreatitis were included in the study.Results:A total of 539 patients with acute pancreatitis were included in this study.They were divided into a survival group（486 patients）and a death group（53 patients）according to whether they survived within 28-d of admission,and the mortality rate of patients within 28-d of admission was 9.8%.LAR was shown to be an independent predictor of all-cause mortality within 28-d of admission in patients with AP by multivariate COX regression analysis（HR,1.59;95%CI,1.23-2.05;P<0.001）.the Area Under the Curve（AUC）value for LAR was 74.26%（95%CI:67.02%-81.50%）,which was higher than that for arterial blood lactate（AUC=71.25%）and serum albumin（AUC=65.92%）alone.It was not inferior even when compared to Sepsis-related Organ Failure Assessment（SOFA）（AUC=75.15%）.The optimal cutoff value for separating the survival and death groups according to Receiver Operating Characteristic（ROC）was found to be 1.1124(×10-1).plotting Kaplan-Meier analysis with this cutoff value showed that patients with LAR≥1.1124(×10-1)had significantly higher all-cause mortality within 28-d of admission than those with LAR<1.1124(×10-1)（P<0.001）.The final subgroup analysis showed no significant interaction of LAR with each subgroup（P for interaction:0.06-0.974）.Conclusion:LAR can be used as an independent predictor of all-cause mortality in AP patients within 28-d of admission,with superior prognostic performance than arterial blood lactate or serum albumin alone. |
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