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Background No studies have been published on the correlation between lactic dehydrogenase-to-albumin ratio (LAR) and poor prognosis of acute kidney injury (AKI) patients, warranting further research. This analysis sought to investigate the prognostic implication of LAR in critically ill patients with AKI. Methods The present study enrolled 11,046 and 5180 adults with AKI from the Medical Information Mart for Intensive Care III (MIMIC III) and MIMIC IV, respectively. Data from MIMIC IV were identified as the training cohort, and those from MIMIC III were identified as the validation cohort. We applied multivariate regression analysis to identify the link between LAR and all-cause mortality. Restricted cubic spline (RCS) was conducted to figure out the correlation between LAR and in-hospital mortality. Furthermore, we carried out stratification analyses to examine if the effects of LAR on in-hospital mortality were consistent across various subclasses. Results The level of LAR was remarkably higher in the in-hospital non-survivor group ( p < 0.001). Furthermore, the increased LAR group presented a remarkably higher rate of in-hospital mortality at AKI stages 1, 2, and 3 compared with the decreased LAR group (all p < 0.001). Multivariate regression analyses exhibited the independent prognostic significance of LAR for all-cause mortality (all p < 0.001). MIMIC III observed concordant results. RCS indicated a non-linear correlation between LAR and in-hospital death ( P for non-linearity < 0.001). The relationship between LAR and in-hospital mortality was still significant in patients with various subclasses. Conclusions Elevated LAR at admission is a prognostic risk factor for critically ill patients with AKI. Supplementary Information The online version contains supplementary material available at 10.1007/s10157-023-02321-5.

Background Non-small cell lung cancer (NSCLC) survivors are at an increased risk of developing second primary malignancies, such as small cell lung cancer. This paper sought to establish a prognostic nomogram to assess overall survival (OS) in patients with second primary small cell lung cancer (SPSCLC) after NSCLC. Methods 420 patients who developed SPSCLC after NSCLC were randomly split into the training and validation groups. A nomogram was established by stepwise regression. Area under the curve (AUC) and calibration plots were applied to assess the prognostic performance of the nomogram. Concordance index (C-index), integrated discrimination improvement (IDI), net reclassification index (NRI) and decision curve analysis (DCA) were performed to compare the nomogram with the American Joint Committee on Cancer (AJCC) 8th staging system. Survival risk classification was constructed based on the nomogram. Results Five variables were chosen to construct the nomogram. The AUC showed that it had a satisfactory discrimination ability. All calibration plots displayed good concordance between nomogram and observation. The C-index, IDI, NRI and DCA showed the nomogram was superior to the AJCC 8th staging system. The Kaplan-Meier curves suggested huge differences in prognosis among the three risk groups. Conclusion This study build a nomogram and risk stratification system for predicting probabilities of OS in patients with SPSCLC after NSCLC, which can help clinicians in individualized survival assessment and treatment decisions.

Background: False aneurysm of ascending aorta is a rare and life-threatening disease. Most of them occur after cardiovascular surgery and have obvious clinical symptoms. Case presentation: A very healthy adult male was admitted to hospital due to mediastinal space occupying during routine physical examination. The patient had no history of surgery and no clinical symptoms. He was diagnosed with a pseudoaneurysm of the ascending aorta and underwent internal suture of the aneurysm with peripheral cardiopulmonary bypass. We also found that there was a kind of circular weak part in front of the ascending aorta, with a diameter of about 2cm. We don't know if he has immune related or unknown diseases related to the middle layer of the aorta. Finally, the patient recovered well. Conclusions: This case report can improve the awareness of the rare diseases of pseudoaneurysm of ascending aorta, and the diagnosis of ascending aortic pseudoaneurysm should not be ignored in patients with mediastinal space occupying lesions found in routine physical examination.