The relationship between lactate to albumin ratio and in-hospital mortality in critically ill patients with acute decompensated heart failure

Aim: This study aimed to evaluate the association between admission lactate to albumin ratio (LAR) and in-hospital mortality in critically ill patients hospitalized with acute decompensated heart failure (ADHF).Material sand Methods: This retrospective single-center study included 87 adult patients admitted to a coronary intensive care unit (ICU) with ADHF. LAR was calculated using admission laboratory values. Patients were classified according to in-hospital survival status. Clinical, laboratory, and echocardiographic variables were analyzed to identify predictors of in-hospital mortality. Receiver operating characteristic (ROC) analysis was performed to assess the prognostic performance of the LAR.Results: In-hospital mortality occurred in 29 of 87 patients (33.3%). Median lactate levels were significantly higher in non-survivors compared with survivors (3.47 vs. 2.10 mmol/L, p < 0.001). The LAR was also higher in non-survivors (0.93 vs. 0.59, p = 0.002), while left ventricular ejection fraction (LVEF) was lower (28.2% vs. 36.1%, p = 0.006). In multivariable logistic regression analysis, mechanical ventilation (adjusted OR 80.8, p < 0.001) and LVEF (adjusted OR 0.92 per %, p = 0.016) were independently associated with in-hospital mortality, whereas the LAR was not (p = 0.266). ROC analysis demonstrated fair discrimination for the LAR in predicting mortality (AUC 0.706).Conclusion: Although higher LAR values were associated with mortality in unadjusted analysis, this marker did not provide independent prognostic value beyond established indicators of disease severity in critically ill patients with ADHF.