Association Between Lactate-to-albumin Ratio and 28-day Mortality in Patients with Ventilator-associated Pneumonia
School of the First Clinical Medicine, Gannan Medical University, Ganzhou 341000, China
| Abstract: | Background: Ventilator-associated pneumonia (VAP) is a frequent complication for those receiving invasive mechanical ventilation in the ICU, exerts significant impacts on clinical outcomes. We aimed to explore the association between LAR and 28-day mortality in those suffering from VAP. Methods: This investigation utilized clinically granular data from MIMIC-IV database. Altogether, 591 patients with VAP were ultimately collected for analysis. Participants were categorized into three groups in accordance with tertiles of LAR. The key clinical endpoint was 28-day all-cause mortality. Univariate Cox Regression, Multivariate Cox Regression, RCS (Restricted cubic spline), Kaplan–Meier curve, and Subgroup analyses were used to examine the association between LAR and 28-day mortality among critical care patients with VAP. Results: Of the VAP patients, 22.0% succumbed within the 28-day observational window. According to the multivariable Cox regression analysis, LAR independently influenced the 28-day mortality risk in VAP patients (adjusted HR = 1.22, 95% CI: 1.06~1.39, P = 0.005). Restricted cubic spline analysis revealed a positive correlation between LAR and 28-day mortality. Subgroup analyses confirmed consistent associations across diverse patient characteristics. Kaplan-Meier curves demonstrated that patients in the high-LAR group had significantly lower survival probabilities compared to the low- and medium-LAR groups, suggesting that patients with VAP who have elevated LAR face a greater risk of mortality within 28 days. Conclusion: In summary, our study revealed a positive dose-response association between LAR and 28-day mortality in patients with VAP, suggesting that LAR is identified as an independent risk factor for unfavorable clinical outcomes in this population. |
| Keywords: | Lactate-to-albumin Ratio; Ventilator-associated Pneumonia; 28-day All-cause Mortality |
| DOI: | 10.57237/j.mrf.2026.01.001 |
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Received: 8 December 2025
Accepted: 15 January 2026
Published Online: 20 January 2026
References
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