Correlation between lactate dehydrogenase to albumin ratio and prognosis of patients with acute pancreatitis

Objective: The aim of this study is to evaluate the relationship between lactate dehydrogenase to albumin ratio (LAR) and the prognosis of patients with acute pancreatitis (AP), and further validate its clinical utility as a biomarker. Methods: We retrospectively analyzed the clinical data of 82 patients with acute pancreatitis admitted to the Intensive Care Unit of Shanghai East Hospital from 2019 to 2024. Based on their 28-day survival outcomes, the patients were categorized into a death group(n=10) and a survival group(n=72). Various clinical indicators, including age, gender, hemoglobin (Hb), total bilirubin (TB), and creatinine (Cr), were evaluated to further identify independent prognostic factors. The predictive power of LAR values was evaluated through Cox multivariate regression analysis and ROC curve, while Kaplan Meier survival analysis was used to analyze the survival differences among patients with different LAR levels. To verify the robustness of the results, we further independently validated the predictive ability of LAR using the eICU database. Results: Compared with the survival group, the LAR of patients in the death group was significantly increased (p<0.01), and the ICU hospitalization time and total hospitalization time were significantly prolonged. Cox regression analysis showed that LAR was an independent predictor of 28-day mortality in AP patients (HR 1.03; 95% CI: 1.01-1.06). ROC analysis shows that the AUC of LAR is 0.943 and the cutoff value is 29.050. The 28-day mortality rate of patients in the high LAR group was significantly higher than that in the low LAR group (p<0.01). In the validation of eICU database, LAR also showed high prognostic predictive performance (AUC=0.898), indicating that this indicator has strong stability and universality. Concliusions: LAR is an independent risk factor for 28-day mortality in AP patients and can effectively identify high-risk patients.