Application value of peripheral blood LAR in predicting the outcome of severe pneumonia patients

Ma Di; Hong Feng; He Kun; Hong Yahua

doi:10.3969/j.issn.1002-1949.2025.07.005

Abstract：Objective To explore the application value of the dynamic changes of the peripheral blood lactate dehydrogenase to albumin ratio(LAR)in predicting the outcome of severe pneumonia patients.Methods A total of 120 patients with severe pneumonia admitted to the Department of Intensive Care Medicine,the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from July 2021 to March 2024 were selected.Disease outcomes were counted.Clinical data and peripheral blood LAR levels were compared in the patients with different disease outcomes.The correlation between laboratory indicators[white blood cell count(WBC),procalcitonin(PCT),LAR,C-reactive protein(CRP)]and the severity of severe pneumonia was analyzed.Logistic regression analysis was used to investigate the relationship between LAR in peripheral blood and the outcomes of severe pneumonia patients.Restrictive cubic spline(RCS)curve was used to analyze the relationship between peripheral blood LAR and the outcome of severe pneumonia patients;the survival status of severe pneumonia patients with different LAR levels in peripheral blood was compared;the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of LAR for the outcome of patients with severe pneumonia.Results Of the 120 patients with severe pneumonia,27 died within 28 days,with a mortality rate of 22.50％(27/120).The proportion of respiratory failure,age,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,WBC,PCT,CRP and LAR levels in deceased patients were higher than those in survivors(P＜0.05).Pearson analysis showed that the levels of WBC,PCT,CRP and LAR in peripheral blood of patients with severe pneumonia were positively correlated with APACHE Ⅱ scores(P＜0.05).Logistic regression analysis showed that the level of peripheral blood LAR was an influencing factor for the outcomes of severe pneumonia patients before and after adjusting confounding factors(P＜0.05).RCS analysis showed that the level of peripheral blood LAR was nonlinearly related to the outcomes of severe pneumonia patients(P＜0.05).The survival rate of severe pneumonia patients with high-level LAR was 64.06％,which was significantly lower than that of patients with low-level LAR(92.86％)(P＜0.05);ROC curve showed that area under the curve(AUC)value of peripheral blood LAR for predicting the outcomes of severe pneumonia patients was 0.746,which was not significantly different from the AUC of WBC,PCT and CRP.The AUC value of the combination of WBC,PCT,CRP and LAR in predicting the outcomes of severe pneumonia patients was 0.949,which was greater than the AUC value of the combination of WBC,PCT and CRP(P＜0.05).Conclusions LAR in peripheral blood of severe pneumonia patients may be a predictor of the patient's condition,and LAR combined with conventional markers has significant predictive value for the patient's condition.It helps to warn of the risk of early poor outcomes in severe pneumonia patients and facilitates effective clinical intervention measures.