---
title: "Lactate dehydrogenase–to–albumin ratio (LAR) predicts mortality in ICU sepsis-induced coagulopathy"
id: "pubmed-42554150"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42554150"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42554150/"
doi: "10.1080/17474086.2026.2715457"
published_at: "2026-08-05T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Lactate dehydrogenase–to–albumin ratio (LAR) predicts mortality in ICU sepsis-induced coagulopathy
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42554150
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42554150/)
- **DOI:** [10.1080/17474086.2026.2715457](https://doi.org/10.1080%2F17474086.2026.2715457)
- **Published At:** 2026-08-05T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Study used data from 1,500 patients with **sepsis-induced coagulopathy (SIC)** drawn from the MIMIC ICU database to evaluate the prognostic value of the **lactate dehydrogenase-to-albumin ratio (LAR)**. - Primary outcome was **30-day all-cause mortality**; secondary outcome was **90-day mortality**. - Patients were divided into low-, medium-, and high-LAR groups; medium- and high-LAR groups had significantly higher 30- and 90-day mortality (p < 0.001) compared with the low-LAR group. - In fully adjusted Cox regression, natural-log transformed **ln(LAR)** was positively associated with 30-day mortality (HR 1.17, 95% CI 1.03–1.31, p = 0.013) and 90-day mortality (HR 1.17, 95% CI 1.04–1.30, p = 0.007). - The relationship between **ln(LAR)** and 30-day mortality was non-linear (P-non-linear = 0.007) with an identified inflection point at **ln(LAR) = 4.57**; above this point prognosis worsened. - A statistically significant interaction was observed for **dobutamine therapy** (P-interaction = 0.03), indicating treatment effect modification in subgroup analysis. - Authors conclude that higher **LAR** is associated with poorer prognosis in ICU patients with **SIC**, particularly when ln(LAR) exceeds 4.57. - Study design: retrospective cohort analysis of the MIMIC database using Kaplan–Meier curves, Cox regression, restricted cubic splines, and subgroup analyses to assess associations and non-linearity.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Association between the lactate dehydrogenase-to-albumin ratio and prognosis in ICU sepsis-induced coagulopathy patients [Yufeng Jin](https://pubmed.ncbi.nlm.nih.gov/?term=Jin+Y&cauthor_id=42554150)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42554150/#full-view-affiliation-1 "SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China."), [Dong He](https://pubmed.ncbi.nlm.nih.gov/?term=He+D&cauthor_id=42554150)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42554150/#full-view-affiliation-1 "SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China."), [Yulong Xue](https://pubmed.ncbi.nlm.nih.gov/?term=Xue+Y&cauthor_id=42554150)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42554150/#full-view-affiliation-1 "SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.") Affiliations Expand ### Affiliation * 1 SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China. * PMID: **42554150** * DOI: [ 10.1080/17474086.2026.2715457 ](https://doi.org/10.1080/17474086.2026.2715457) Item in Clipboard # Association between the lactate dehydrogenase-to-albumin ratio and prognosis in ICU sepsis-induced coagulopathy patients Yufeng Jin et al. Expert Rev Hematol. 2026. Show details Display options Display options Format Abstract PubMed PMID Expert Rev Hematol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Expert+Rev+Hematol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Expert+Rev+Hematol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42554150/) . 2026 Aug 5. doi: 10.1080/17474086.2026.2715457. Online ahead of print. ### Authors [Yufeng Jin](https://pubmed.ncbi.nlm.nih.gov/?term=Jin+Y&cauthor_id=42554150)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42554150/#short-view-affiliation-1 "SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China."), [Dong He](https://pubmed.ncbi.nlm.nih.gov/?term=He+D&cauthor_id=42554150)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42554150/#short-view-affiliation-1 "SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China."), [Yulong Xue](https://pubmed.ncbi.nlm.nih.gov/?term=Xue+Y&cauthor_id=42554150)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42554150/#short-view-affiliation-1 "SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.") ### Affiliation * 1 SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China. * PMID: **42554150** * DOI: [ 10.1080/17474086.2026.2715457 ](https://doi.org/10.1080/17474086.2026.2715457) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Sepsis-induced coagulopathy (SIC) is a severe complication of sepsis with high mortality. The lactate dehydrogenase-to-albumin ratio (LAR), a composite marker of cell injury and inflammation, is closely associated with sepsis prognosis, but its role in SIC remains unclear. **Research design and methods:** Data from 1,500 SIC patients in the Medical Information Mart for Intensive Care database were used. The primary outcome was 30-day all-cause mortality, and the secondary outcome was 90-day mortality. Kaplan-Meier curves, Cox regression, and restricted cubic splines were used to assess the association between LAR and mortality rates. Subgroup analyses explored potential effect modification across study populations. **Results:** Compared with the low-LAR group, medium- and high-LAR groups exhibited significantly higher 30- and 90-day mortality rates (_p_ < 0.001). The fully adjusted Cox model revealed the positive correlations of ln(LAR) with 30-day (HR = 1.17, 95% CI: 1.03-1.31, _p_ = 0.013) and 90-day mortality rates (HR = 1.17, 95% CI: 1.04-1.30, _p_ = 0.007). The relationship between ln(LAR) and 30-day mortality rate was non-linear (P-non-linear = 0.007), with an inflection point at 4.57. An interaction was observed for dobutamine therapy (P-interaction = 0.03). **Conclusions:** LAR is associated with poor prognosis in patients with SIC, especially once ln(LAR) surpasses 4.57. **Keywords:** MIMIC; Sepsis-induced coagulopathy; lactate dehydrogenase-to-albumin ratio; prognosis. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Association between lactate-to-albumin ratio and mortality in patients with sepsis-induced coagulopathy: a retrospective cohort study. ](https://pubmed.ncbi.nlm.nih.gov/41957417/) Zhu Y, Li Z, Zhou T, Xu H.Zhu Y, et al.Sci Rep. 2026 Apr 9;16(1):16846. doi: 10.1038/s41598-026-47634-z.Sci Rep. 2026.PMID: 41957417Free PMC article. * [ Increased lactate dehydrogenase to albumin ratio is associated with short-term mortality in septic ICU patients: A retrospective cohort study. ](https://pubmed.ncbi.nlm.nih.gov/39969341/) Xiao X, Wu JJ, Liu Y, Suo Z, Zhang H, Xu HB.Xiao X, et al.Medicine (Baltimore). 2024 Dec 27;103(52):e40854. doi: 10.1097/MD.0000000000040854.Medicine (Baltimore). 2024.PMID: 39969341Free PMC article. * [ Relationship between lactate-albumin ratio and all-cause mortality in chronic kidney disease without continuous renal replacement therapy in the intensive care unit ward: a retrospective analysis of the MIMIC-IV database. ](https://pubmed.ncbi.nlm.nih.gov/41340039/) Xie R, Xie H, Li L, Wen R, Tan X, Zhu F, Li P, Qin J.Xie R, et al.BMC Nephrol. 2025 Dec 3;26(1):685. doi: 10.1186/s12882-025-04588-0.BMC Nephrol. 2025.PMID: 41340039Free PMC article. * [ The association between lactate dehydrogenase to serum albumin ratio and the 28-day mortality in patients with sepsis-associated acute kidney injury in intensive care: a retrospective cohort study. ](https://pubmed.ncbi.nlm.nih.gov/37194715/) Liang M, Ren X, Huang D, Ruan Z, Chen X, Qiu Z.Liang M, et al.Ren Fail. 2023 Dec;45(1):2212080. doi: 10.1080/0886022X.2023.2212080.Ren Fail. 2023.PMID: 37194715Free PMC article. * [ Association of lactate to albumin ratio with short-term and long-term mortality in critically ill patients with heart failure complicated by sepsis: a retrospective study using the MIMIC-IV database. ](https://pubmed.ncbi.nlm.nih.gov/41063835/) Wu Y, Wang L, Wen Q.Wu Y, et al.Front Cardiovasc Med. 2025 Sep 23;12:1636375. doi: 10.3389/fcvm.2025.1636375. eCollection 2025.Front Cardiovasc Med. 2025.PMID: 41063835Free PMC article. 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