tetano
Editor, Senior Moderator
BMC Anesthesiol
. 2024 Dec 19;24(1):459.
doi: 10.1186/s12871-024-02843-9. Clinical significance of lactate-to-albumin ratio in patients with influenza A virus-induced acute respiratory distress syndrome: a single-center retrospective study
Jinhui Gao[SUP] #[/SUP][SUP] 1 [/SUP], Xuanzhe Yang[SUP] #[/SUP][SUP] 2 [/SUP], Xiang Fang[SUP] 1 [/SUP], Ziyi Zhang[SUP] 1 [/SUP], Dapeng Wang[SUP] 3 [/SUP], Jiajia Wang[SUP] 4 [/SUP]
Affiliations
Background: The lactate-to-albumin ratio (LAR) is predictive of disease prognosis in some cases. However, the clinical significance of LAR in patients with influenza A virus-induced acute respiratory distress syndrome (ARDS) has yet to be explored. This study aims to investigate whether LAR can be used as a predictor of influenza A virus-induced ARDS.
Methods: In this single-center retrospective study, we enrolled 105 patients with influenza A virus pneumonia into the study and divided the patients into an ARDS group (74 patients) and a non-ARDS group (31 patients) during hospitalization. Clinical characteristics and laboratory data were collected within 24 h after admission. We explored the risk factors for ARDS using logistic regression analysis. The predictive performance of potential risk factors for ARDS and ARDS-associated complications were evaluated by receiver operating characteristic (ROC) curves, and Pearson's correlation analysis was used to evaluate the correlations between risk factors and clinical and laboratory variables.
Results: LAR was an independent predictor for the development of ARDS in patients with influenza A virus pneumonia and was significantly predictive for ARDS. LAR's area under the curve (AUC) was higher than that of lactate and albumin alone; its AUC was 0.878, with a sensitivity of 71.6% and a specificity of 96.8%. The optimal ROC threshold for distinguishing ARDS from non-ARDS cases was 44.81 × 10[SUP]- 3[/SUP]. Correlation analysis indicated that LAR was positively associated with duration of invasive ventilation, and APACHE II and SOFA scores in ARDS patients but was negatively associated with PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] (p < 0.001). Subsequent ROC curve analysis determined that LAR was a robust predictor for the 14-day invasive ventilation (AUC = 0.924), septic shock (AUC = 0.860), and hepatic injury (AUC = 0.905) in hospitalized ARDS patients. It also showed a promising predictive value for 28-day mortality (AUC = 0.881).
Conclusion: LAR strongly predicted ARDS development in patients with influenza A virus pneumonia. It showed a significant correlation with disease severity and provided promising predictive efficiency for extrapulmonary complications and 28-day mortality in patients with influenza A virus-induced ARDS.
Keywords: Acute respiratory distress syndrome; Influenza A virus; Lactate-to-albumin ratio.
. 2024 Dec 19;24(1):459.
doi: 10.1186/s12871-024-02843-9. Clinical significance of lactate-to-albumin ratio in patients with influenza A virus-induced acute respiratory distress syndrome: a single-center retrospective study
Jinhui Gao[SUP] #[/SUP][SUP] 1 [/SUP], Xuanzhe Yang[SUP] #[/SUP][SUP] 2 [/SUP], Xiang Fang[SUP] 1 [/SUP], Ziyi Zhang[SUP] 1 [/SUP], Dapeng Wang[SUP] 3 [/SUP], Jiajia Wang[SUP] 4 [/SUP]
Affiliations
- PMID: 39695390
- PMCID: PMC11657767
- DOI: 10.1186/s12871-024-02843-9
Background: The lactate-to-albumin ratio (LAR) is predictive of disease prognosis in some cases. However, the clinical significance of LAR in patients with influenza A virus-induced acute respiratory distress syndrome (ARDS) has yet to be explored. This study aims to investigate whether LAR can be used as a predictor of influenza A virus-induced ARDS.
Methods: In this single-center retrospective study, we enrolled 105 patients with influenza A virus pneumonia into the study and divided the patients into an ARDS group (74 patients) and a non-ARDS group (31 patients) during hospitalization. Clinical characteristics and laboratory data were collected within 24 h after admission. We explored the risk factors for ARDS using logistic regression analysis. The predictive performance of potential risk factors for ARDS and ARDS-associated complications were evaluated by receiver operating characteristic (ROC) curves, and Pearson's correlation analysis was used to evaluate the correlations between risk factors and clinical and laboratory variables.
Results: LAR was an independent predictor for the development of ARDS in patients with influenza A virus pneumonia and was significantly predictive for ARDS. LAR's area under the curve (AUC) was higher than that of lactate and albumin alone; its AUC was 0.878, with a sensitivity of 71.6% and a specificity of 96.8%. The optimal ROC threshold for distinguishing ARDS from non-ARDS cases was 44.81 × 10[SUP]- 3[/SUP]. Correlation analysis indicated that LAR was positively associated with duration of invasive ventilation, and APACHE II and SOFA scores in ARDS patients but was negatively associated with PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] (p < 0.001). Subsequent ROC curve analysis determined that LAR was a robust predictor for the 14-day invasive ventilation (AUC = 0.924), septic shock (AUC = 0.860), and hepatic injury (AUC = 0.905) in hospitalized ARDS patients. It also showed a promising predictive value for 28-day mortality (AUC = 0.881).
Conclusion: LAR strongly predicted ARDS development in patients with influenza A virus pneumonia. It showed a significant correlation with disease severity and provided promising predictive efficiency for extrapulmonary complications and 28-day mortality in patients with influenza A virus-induced ARDS.
Keywords: Acute respiratory distress syndrome; Influenza A virus; Lactate-to-albumin ratio.