The Predictive Value of Lactate/Albumin Ratio for the Prognosis of Acute Traumatic Brain Injury-A Study Based on the MIMIC-Ⅳ Database
HUANG Guangshuai
XU Tie
PENG Yigen
Abstract：Objective To investigate the predictive value of the lactate-to—albumin ratio(LAR)for 30-day mortality in patients with traumatic brain injury(TBI).Methods Data of TBI patients admitted to the intensive care unit at Beth Israel Deaconess Medical Center from 2012 to 2018 were retrospectively collected from the MIMIC-Ⅳ database.Patients were divid-ed into the death group(n=88)and the survival group(n=479)based on their 30-day survival status.Differences in demographic information,laboratory data,clinical scores,and length of hospital stay between the two groups were analyzed.A multivariate logistic regression model was used to analyze the association between LAR and 30-day mortality after TBI.The predictive value of LAR for 30-day mortality was assessed using the a receiver operating characteristic(ROC)curve.The optimal cutoff value of LAR was determined based on the maximum Youden index.Patients were further divided into two subgroups according to the cutoff value,and subgroup analyses were performed to compare differences in various indicators between the high and low LAR groups.Results A total of 585 patients were included in the study,with 497 survivors and 88 deaths.The death group had significantly higher levels of LAR and lactate compared to the survival group(P＜0.05).Univariate logistic regression analysis showed that coronary heart disease,total length of hospital stay,mean arterial pressure,SOFA score,APACHE Ⅱ score,and LAR were factors influencing 30-day mortality in TBI patients.Multivariate logistic regression analysis demonstrated that LAR(OR=2.151,95％CI:1.450-3.190)and APACHE Ⅱ score(OR=1.182,95％CI:1.104-1.265)were independent risk factors for 30-day mortality after TBI(P＜0.05).ROC analysis showed that the AUCs of LAR and APACHE Ⅱ score for predicting poor outcomes in TBI were 0.806 and 0.804,respectively.Subgroup analysis revealed that the high LAR group had significantly high-er 30-day mortality,SOFA scores,and APACHE Ⅱ scores,and lower GCS scores within 24 hours of admission compared to the low LAR group(P＜0.05).Conclusion LAR is independently associated with 30-day mortality in TBI patients and has predic-tive value for 30-day mortality after TBI.
Keywords：Traumatic brain injuryLactate-to-albumin ratioPrognosis predictionMIMIC-Ⅳ database
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 65-70 )