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已发表论文
乳酸脱氢酶与白蛋白比值作为预测重症急性胰腺炎患者院内死亡率的指标：一项 18 年队列研究的证据
Authors Zou Y, Kuang M, Xiong S, Xu X, Li X, Ding L, He C, Li N, Ke H, Huang X, Lei Y, Xiong H, He W, Xia L, Lu N , Wan J, Zhu Y
Received 12 June 2025
Accepted for publication 18 October 2025
Published 27 October 2025 Volume 2025:18 Pages 14927—14939
DOI https://doi.org/10.2147/JIR.S546481
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Ning Quan
Yaoyu Zou,* Maobin Kuang,* Shixuan Xiong,* Xin Xu, Xueyang Li, Ling Ding, Cong He, Nianshuang Li, Huajing Ke, Xin Huang, Yupeng Lei, Huifang Xiong, Wenhua He, Liang Xia, Nonghua Lu, Jianhua Wan, Yin Zhu
Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yin Zhu, Email ndyfy01977@ncu.edu.cn Jianhua Wan, Email ndyfy07545@ncu.edu.cn
Background: Severe acute pancreatitis (SAP) carries a mortality rate of up to 30%. This study evaluated the association between the lactate dehydrogenase-to-albumin ratio (LAR) and in-hospital mortality in patients with predicted SAP.
Methods: A total of 4605 patients (APACHE II ≥ 8) admitted to the First Affiliated Hospital of Nanchang University from 2005 to 2023 were retrospectively analyzed. Cox regression, restricted cubic splines, Kaplan–Meier curves, and Log rank tests assessed the association between LAR and mortality. Receiver operating characteristic (ROC) and time-dependent ROC curves evaluated predictive performance. Subgroup and sensitivity analyses confirmed robustness.
Results: Elevated LAR independently predicted in-hospital mortality (adjusted HR per SD: 1.14; 95% CI: 1.09– 1.19; P < 0.001). Kaplan–Meier curves showed significantly lower survival in high-LAR groups (P < 0.05). LAR outperformed LDH, albumin, SIRS, and APACHE II (AUC = 0.847; 95% CI: 0.826– 0.869). A non-linear association with a threshold at LAR = 20.58 was identified. Predictive value remained stable across etiologies and both short-term (≤ 14 days) and long-term (30– 90 days) mortality. Stronger associations were seen in younger, male, hypertriglyceridemic patients and those without persistent multiple organ failure.
Conclusion: Higher LAR was associated with greater in-hospital mortality among patients with predicted severe acute pancreatitis; LAR may serve as a simple, low-cost adjunct for early risk assessment.
Keywords: acute pancreatitis, lactate dehydrogenase-to-albumin ratio, mortality, survival analysis
Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yin Zhu, Email ndyfy01977@ncu.edu.cn Jianhua Wan, Email ndyfy07545@ncu.edu.cn
Background: Severe acute pancreatitis (SAP) carries a mortality rate of up to 30%. This study evaluated the association between the lactate dehydrogenase-to-albumin ratio (LAR) and in-hospital mortality in patients with predicted SAP.
Methods: A total of 4605 patients (APACHE II ≥ 8) admitted to the First Affiliated Hospital of Nanchang University from 2005 to 2023 were retrospectively analyzed. Cox regression, restricted cubic splines, Kaplan–Meier curves, and Log rank tests assessed the association between LAR and mortality. Receiver operating characteristic (ROC) and time-dependent ROC curves evaluated predictive performance. Subgroup and sensitivity analyses confirmed robustness.
Results: Elevated LAR independently predicted in-hospital mortality (adjusted HR per SD: 1.14; 95% CI: 1.09– 1.19; P < 0.001). Kaplan–Meier curves showed significantly lower survival in high-LAR groups (P < 0.05). LAR outperformed LDH, albumin, SIRS, and APACHE II (AUC = 0.847; 95% CI: 0.826– 0.869). A non-linear association with a threshold at LAR = 20.58 was identified. Predictive value remained stable across etiologies and both short-term (≤ 14 days) and long-term (30– 90 days) mortality. Stronger associations were seen in younger, male, hypertriglyceridemic patients and those without persistent multiple organ failure.
Conclusion: Higher LAR was associated with greater in-hospital mortality among patients with predicted severe acute pancreatitis; LAR may serve as a simple, low-cost adjunct for early risk assessment.
Keywords: acute pancreatitis, lactate dehydrogenase-to-albumin ratio, mortality, survival analysis