Prognostic value of lactic dehydrogenase-to-albumin ratio in critically ill patients with acute respiratory distress syndrome: a retrospective cohort study

Zhang, Fushuai; Zhang, Mengyu; Niu, Zongge; Sun, Lina; Kang, Xiuhe; Qu, Yiqing

doi:10.21037/jtd-23-1238

Cited by 2 publications

(1 citation statement)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The clinical spectrum of COVID-19 is broad, encompassing asymptomatic carriers, mild upper respiratory tract infections, and severe pneumonia with acute respiratory distress syndrome (ARDS) necessitating Intensive Care Unit (ICU) admission [9][10][11][12][13][14]. The variability in disease expression is a hallmark of COVID-19, with several factors influencing disease severity and outcomes.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Mortality Predictors in COVID-19 Intensive Care Unit Patients: Insights into Age, Procalcitonin, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Ferritin Lactate Index

Ince,

Alkan Bilik,

Ince

2024

Diagnostics

View full text Add to dashboard Cite

Introduction: Numerous studies suggest that alterations in blood parameters, such as changes in platelet, lymphocyte, hemoglobin, eosinophil, and basophil counts; increased neutrophil counts; and elevated neutrophil/lymphocyte and platelet/lymphocyte ratios, signal COVID-19 infection and predict worse outcomes. Leveraging these insights, our study seeks to create a predictive mortality model by assessing age and crucial laboratory markers. Materials and Methods: Patients were categorized into two groups based on their hospital outcomes: 130 survivors who recovered from their Intensive Care Unit (ICU) stay (Group 1) and 74 who died (Group 2). We then developed a predictive mortality model using patients’ age, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), procalcitonin levels, and ferritin lactate (FL) index results. Results: A total of 204 patients were included. Patients in Group 2 had a notably higher mean age compared to those in Group 1 (76 ± 11 vs. 66 ± 15 years) (p < 0.001). Using specific cut-off values, our analysis revealed varying effectiveness in predicting COVID-19 mortality: Those aged over 73 years showed 74% sensitivity and 60% specificity, with an area under the curve (AUC) of 0.701. Procalcitonin levels above 0.35 ng/mL balanced true-positive and -negative identifications well, achieving an AUC of 0.752. The FL index, with a threshold of 1228 mg/dL, had 68% sensitivity and 65% specificity with an AUC of 0.707. A PLR higher than 212 resulted in 48% sensitivity and 69% specificity, with an AUC of 0.582. An NLR higher than 5.8 resulted in 55% sensitivity and 63% specificity, with an AUC of 0.640, showcasing diverse predictive accuracies across parameters. The statistical analysis evaluated the effects of age (>73), procalcitonin levels (>0.35), FL > 1228, PLR > 212, and NLR > 5.8 on mortality variables using logistic regression. Ages over 73 significantly increased event odds by 2.1 times (p = 0.05), procalcitonin levels above 0.35 nearly quintupled the odds (OR = 5.6, p < 0.001), high FL index levels more than tripled the odds (OR = 3.5, p = 0.003), a PLR > 212 significantly increased event odds by 3.5 (p = 0.030), and an NLR > 5.8 significantly increased event odds by 1.6 (p = 0.043). Conclusions: Our study highlights significant predictors of mortality in COVID-19 ICU patients, including advanced age, elevated procalcitonin, FL index levels, the PLR, and the NLR.

show abstract

Section: Introductionmentioning

confidence: 99%

Evaluating Mortality Predictors in COVID-19 Intensive Care Unit Patients: Insights into Age, Procalcitonin, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Ferritin Lactate Index

Ince,

Alkan Bilik,

Ince

2024

Diagnostics

View full text Add to dashboard Cite

show abstract

Nonlinear correlation between prognostic nutritional indices (PNI) and patients with sepsis: a retrospective study based on the MIMIC database.

Han,

Qi,

Yuan

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: The objective of this study was to explore the association between PNI and mortality among sepsis patients. Methods: Data in the present study were obtained from MIMIC-IV. PNI was calculated as follows: serum albumin concentration (g/L) + 0.005 × lymphocyte count. The primary outcome of this study was in-hospital mortality. COX proportional hazard regression analysis was conducted to examine the association between PNI and in-hospital mortality. A linear trend was evaluated by including the median PNI of each group as a continuous variable in the model. Restricted cubic spline (RCS) analysis was employed to explore the linear relationship between PNI and the risk of in-hospital mortality and to investigate the interaction between PNI and different factors. Results: A total of 2794 patients were included in this study and divided into four groups (Q1-Q4) according to PNI quartile values. In the fully adjusted model, in-hospital mortality of patients in the highest quartile group of PNI values was 49.4% (HR = 0.506, 95% CI: 0.342-0.747, P = 0.001) lower than those in the lowest quartile group, respectively, with a statistically significant trend toward increased risk, Ptrend < 0.001. RCS analysis showed that an L-shaped association between PNI and in-hospital mortality. Subgroup analyses showed a association between PNI and in-hospital mortality in different strata of patients, with a negative correlation between PNI and in-hospital mortality in all groups (HR <1 in each group). Conclusions: There is a strong correlation between low PNI and an increased risk of death during hospitalization in patients with sepsis. An L-shaped association was observed between PNI and in-hospital mortality in patients with sepsis, with an inflection point at 33.99.

show abstract

Prognostic value of lactic dehydrogenase-to-albumin ratio in critically ill patients with acute respiratory distress syndrome: a retrospective cohort study

Cited by 2 publications

References 22 publications

Evaluating Mortality Predictors in COVID-19 Intensive Care Unit Patients: Insights into Age, Procalcitonin, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Ferritin Lactate Index

Evaluating Mortality Predictors in COVID-19 Intensive Care Unit Patients: Insights into Age, Procalcitonin, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Ferritin Lactate Index

Nonlinear correlation between prognostic nutritional indices (PNI) and patients with sepsis: a retrospective study based on the MIMIC database.

Contact Info

Product

Resources

About