文献类型：期刊文献

英文题名：Association between lactate-to-albumin ratio and 28-day ICU mortality in pediatric severe pneumonia patients

作者：Zhang, Yang[1,2,3,4];Guo, Rubing[5];Wang, Li[5];Hu, Jihong[6]

第一作者：张扬

通信作者：Hu, JH[1]

机构：[1]Gansu Univ Chinese Med, Sci Res & Expt Ctr, Lanzhou, Peoples R China;[2]Gansu Univ Chinese Med, Key Lab Dunhuang Med, Minist Educ, Lanzhou, Peoples R China;[3]Gansu Univ Chinese Med, Res Ctr Tradit Chinese Med, Lanzhou, Peoples R China;[4]Gansu Univ Chinese Med, Clin Coll Chinese Med, Lanzhou, Peoples R China;[5]Gansu Univ Chinese Med, Coll Publ Hlth, Lanzhou, Peoples R China;[6]Gansu Univ Chinese Med, Lab & Simulat Training Ctr, Lanzhou, Peoples R China

第一机构：甘肃中医药大学科研实验中心（甘肃省中医药标准化技术委员会秘书处）

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Lab & Simulat Training Ctr, Lanzhou, Peoples R China.|[10735]甘肃中医药大学;

年份：2025

卷号：20

期号：9

外文期刊名：PLOS ONE

收录：;Scopus(收录号：2-s2.0-105015894865);WOS:【SCI-EXPANDED(收录号:WOS:001571579900048)】；

基金：This study was financially supported by the Open Subjects of the Key Laboratory of Dunhuang Medicine, Ministry of Education, in the form of a grant (DHYX20-17) received by YZ. This study was also financially supported by the Open Subjects of the Research Center of Traditional Chinese Medicine, Gansu Province, in the form of a grant (ZYZX-2023-05) received by YZ. This study was also financially supported by the Scientific Research and Innovation Fund Project of Gansu University of Chinese Medicine in the form of a grant (2023KCYB-7) received by YZ. This study was also financially supported by the General project of Gansu Provincial Joint Scientific Research Fund in the form of a grant (24JRRA880) received by JH. This study was also financially supported by the Experimental Teaching Platform of the Teaching Laboratory Centre in the form of a grant (230516110201) received by JH.

语种：英文

摘要：Introduction The lactate-to-albumin ratio (LAR) has emerged as a promising prognostic biomarker in critical care, reflecting both metabolic dysfunction and inflammatory status. However, its prognostic value in pediatric severe pneumonia remains underexplored. This study aimed to investigate the association between LAR and 28-day ICU mortality in pediatric severe pneumonia patients using data from the Paediatric Intensive Care database. Methods A retrospective cohort study was conducted involving 617 pediatric severe pneumonia patients admitted to the ICU between 2010 and 2018. LAR was calculated as the ratio of lactate (mmol/L) to albumin (g/dL). The primary outcome was 28-day ICU mortality. Cox proportional hazards regression models were used to assess the relationship between LAR and mortality, with restricted cubic splines (RCS) employed to explore potential nonlinear associations. Subgroup analyses were performed based on age, sex, and oxygenation status. Results A significant linear relationship was observed between LAR and 28-day ICU mortality. Each unit increase in log (LAR) was associated with a 2.51-fold higher mortality risk (HR 2.51, 95% CI: 1.73, 3.65; P < 0.001). Kaplan-Meier analysis confirmed that patients in the highest LAR tertile had significantly lower survival probabilities compared to those in the lowest tertile (log-rank P < 0.001). Subgroup analyses revealed consistent associations across age, sex, and oxygenation status, with no significant interactions (all P for interaction>0.05). Conclusions Higher LAR levels are independently associated with increased 28-day ICU mortality in pediatric severe pneumonia patients, demonstrating a linear relationship. These findings highlight LAR as a valuable prognostic tool for early risk stratification and clinical decision-making in this population. Further multicenter studies are needed to validate these results and explore interventions targeting LAR reduction to improve outcomes.