Association between lactate-albumin ratio and 28-day mortality in patients with sepsis-associated acute kidney injury: a retrospective cohort study

The aim of this study was to investigate the correlation between lactate-albumin ratio (LAR) and 28-day mortality in patients with sepsis combined with acute kidney failure (SA-AKI). The study was based on the eICU database and collected data from 1855 patients with SA-AKI. The relationship between LAR and 28-day in-hospital mortality was assessed using multivariate Cox regression models and Kaplan-Meier survival analysis. A generalised summation model was also used to analyse the non-linear relationship between LAR and mortality. The results showed that the 28-day in-hospital mortality rate of the patients was 19.46% (361/1,855), with a significant positive correlation between LAR and mortality (HR: 1.26, 95% CI: 1.18-1.35, p < 0.001). The Kaplan-Meier survival curve showed that the highest quartile of LAR (Q4) had the lowest survival rate. Non-linear analysis showed that when the LAR ratio was less than 2.1, mortality increased with each 1-unit increase in the LAR ratio, with an adjusted hazard ratio of 1.48 (95% CI 1.20, 1.84, p < 0.001). For patients with SA-AKI, a nonlinear relationship between LAR and 28-day risk of death was observed, with higher LAR associated with higher risk of mortality.