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      The value of lactate/albumin ratio for predicting the clinical outcomes of critically ill patients with heart failure

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          Abstract

          Background

          Previous studies have shown that the lactate/albumin (L/A) ratio plays a role in predicting the outcomes of septic shock or severe sepsis. However, the role of the L/A ratio in predicting the outcomes of critically ill patients with heart failure remains unclear. We therefore performed a retrospective study to clarify this issue.

          Methods

          The study was based on the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database and included critically ill adult patients with heart failure. The primary endpoints were 28-day and 1-year all-cause mortality after admission at the intensive care unit.

          Results

          We analyzed 4,562 patients in this study. We divided the participants into five groups according to the L/A ratio: quintile (Q)1 (L/A ratio ≤0.40, n=913), Q2 (0.40< L/A ratio ≤0.51, n=912), Q3 (0.51< L/A ratio ≤0.66, n=912), Q4 (0.66< L/A ratio ≤0.92, n=912), and Q5 (L/A ratio >0.92, n=913). After stratifying by L/A ratio, the risk of 28-day and 1-year mortality were significantly different between the groups (log-rank P<0.001). Compared with the first quintile, the second, third, fourth, and fifth quintiles of the L/A ratio were associated with higher 28-day [hazard ratio (HR) 1.57, 95% confidence interval (CI): 1.21–2.03 for Q3, HR 1.72, 95% CI: 1.34–2.21 for Q4, and HR 3.15, 95% CI: 2.47–4.01 for Q5) and 1-year mortality (HR 1.19, 95% CI: 1.00–1.41 for Q2, HR 1.36, 95% CI: 1.15–1.60 for Q3, HR 1.42, 95% CI: 1.20–1.67 for Q4, and HR 2.46, 95% CI: 2.09–2.89 for Q5). The restricted cubic spline showed that the L/A ratio positively correlated with both 28-day and 1-year all-cause mortality.

          Conclusions

          The L/A ratio could serve as a predictor of short and long-term mortality in critically ill patients with heart failure.

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          Most cited references20

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          Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

          Circulation, 135(10)
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            MIMIC-III, a freely accessible critical care database

            MIMIC-III (‘Medical Information Mart for Intensive Care’) is a large, single-center database comprising information relating to patients admitted to critical care units at a large tertiary care hospital. Data includes vital signs, medications, laboratory measurements, observations and notes charted by care providers, fluid balance, procedure codes, diagnostic codes, imaging reports, hospital length of stay, survival data, and more. The database supports applications including academic and industrial research, quality improvement initiatives, and higher education coursework.
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              Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls

              Most studies have some missing data. Jonathan Sterne and colleagues describe the appropriate use and reporting of the multiple imputation approach to dealing with them
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                Author and article information

                Journal
                Ann Transl Med
                Ann Transl Med
                ATM
                Annals of Translational Medicine
                AME Publishing Company
                2305-5839
                2305-5847
                January 2021
                January 2021
                : 9
                : 2
                : 118
                Affiliations
                [1 ]Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences Shenzhen , Shenzhen, China;
                [2 ]Department of Ambulatory Surgery, Huazhong University of Science and Technology Union Shenzhen Hospital , Shenzhen, China
                Author notes

                Contributions: (I) Conception and design: W Guo, L Zhao; (II) Administrative support: H Yan; (III) Provision of study materials or patients: H Zhao, F Zeng; (IV) Collection and assembly of data: W Guo, L Zhao, W Guo; (V) Data analysis and interpretation: L Zhao, C Peng; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

                [#]

                These authors contributed equally to this work.

                Correspondence to: Hongbing Yan, MD, FACC, FESC. Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences Shenzhen, No. 12, Langshan Road, Nanshan District, Shenzhen, China. Email: hbyanfuwai@ 123456yeah.net .
                Article
                atm-09-02-118
                10.21037/atm-20-4519
                7867948
                33569420
                87cbd80c-4c64-4052-aaa6-9af47ea7e627
                2021 Annals of Translational Medicine. All rights reserved.

                Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

                History
                : 05 June 2020
                : 29 September 2020
                Categories
                Original Article

                lactate/albumin ratio,prognosis,heart failure
                lactate/albumin ratio, prognosis, heart failure

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