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. 2025 Apr 4;25(1):154.
doi: 10.1186/s12890-025-03622-z.

Lactate dehydrogenase to albumin ratio and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease: a retrospective cohort study

Chao-Wei Ding  1 , Shen-Shen Huang  2 , Yan-Hong Xu  3 , Xu Chu  2 , Lan Wang  2 , Yi-Min Mao  2 , Ya-Dong Yuan  4 , Jia-Yong Qiu  5   6
Affiliations

Lactate dehydrogenase to albumin ratio and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease: a retrospective cohort study

Chao-Wei Ding et al. BMC Pulm Med. .

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a global public health challenge and a major cause of death. The lactate dehydrogenase to albumin ratio (LAR) is a simple and practical indicator of disease prognosis, but its prognostic value in acute exacerbation of COPD (AECOPD) remains unclear. Therefore, we aimed to explore the prognostic value of LAR for the short-term all-cause mortality risk in patients with AECOPD.

Methods: This retrospective cohort study included 654 patients with AECOPD from the MIMIC-IV database. LAR was analyzed after natural logarithm transformation and the patients were divided into three groups. The clinical outcome was the 1-month and 3-months all-cause mortality. The relationship between LAR and all-cause mortality was assessed using Kaplan-Meier survival analysis and a Cox regression model. Generalized additive models were employed to identify non-linear relationships, and a subgroup analysis was performed to determine the stability of the results.

Results: The study showed that LAR levels significantly and positively correlated with short-term all-cause mortality in patients with AECOPD. Compared to the low LAR group, patients in the medium LAR group had a significantly increased 1-month all-cause mortality risk, with a hazard ratio (HR) of 1.74 (95% [Confidence Interval, CI] 1.16-2.63, P = 0.008). Patients in the high LAR group had an even higher 1-month all-cause mortality risk, with an HR of 2.58 (95% CI 1.75-3.80, P < 0.001). For 3-month all-cause mortality, patients in the medium LAR group had an HR of 1.54 (95% CI 1.10-2.16, P = 0.012), while those in the high LAR group had an HR of 2.18 (95% CI 1.58-3.01, P < 0.001). The results remained stable in all three adjusted models and in the subgroup analyses. The relationship between LAR and all-cause mortality due to AECOPD was non-linear, with inflection points at 8.13 and 6.05 for 1-month and 3-month all-cause mortality, respectively.

Conclusions: Elevated LAR is an independent predictive indicator of short-term all-cause mortality risk in patients with AECOPD and can be used to improve decision-making for the clinical management of these patients.

Clinical trial number: Not applicable.

Keywords: Albumin; Chronic obstructive pulmonary disease; Lactate dehydrogenase to albumin; MIMIC IV; Mortality.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was based on the latest MIMIC-IV version 3.0 database. Because the analysis used publicly available de-identified data, institutional review board review at the Beth Israel Deaconess Medical Center was waived, and informed consent procedures were not needed. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The flowchart of patient selection
Fig. 2
Fig. 2
Kaplan-Meier curve analysis of all-cause mortality risk for AECOPD patients. A 1-month all-cause mortality risk.B 3-month all-cause mortality risk
Fig. 3
Fig. 3
A nonlinear relationship analysis between LAR and all-cause mortality due to AECOPD. A 1-month all-cause mortality risk. B 3-month all-cause mortality risk
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References

    1. Halpin DMG, Celli BR, Criner GJ, Frith P, López Varela MV, Salvi S, Vogelmeier CF, Chen R, Mortimer K, Montes de Oca M, et al. The GOLD summit on chronic obstructive pulmonary disease in low- and middle-income countries. Int J Tuberculosis Lung Disease: Official J Int Union against Tuberculosis Lung Disease. 2019;23(11):1131–41. - PubMed
    1. Adeloye D, Song P, Zhu Y, Campbell H, Sheikh A, Rudan I, Unit NRGRH. Global, regional, and National prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med. 2022;10(5):447–58. - PMC - PubMed
    1. Global Initiative for Chronic Obstructive Lung Disease. GOLD 2025 report. https://goldcopd.org/2025-gold-report/
    1. Piquet J, Chavaillon JM, David P, Martin F, Blanchon F, Roche N. French college of general hospital respiratory P: High-risk patients following hospitalisation for an acute exacerbation of COPD. Eur Respir J. 2013;42(4):946–55. - PubMed
    1. Qian Y, Cai C, Sun M, Lv D, Zhao Y. Analyses of factors associated with acute exacerbations of chronic obstructive pulmonary disease: A review. Int J Chronic Obstr Pulm Dis. 2023;18:2707–23. - PMC - PubMed

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