Association between the lactate-to-albumin ratio and 28-day all-cause mortality in diabetic ketoacidosis patients: A retrospective cohort study utilizing the MIMIC-IV database

Abstract

Objective The objective of this study was to assess the relationship between the lactate-to-albumin ratio upon hospital admission and the clinical outcomes of critically ill patients with a diagnosis of diabetic ketoacidosis. Methods A retrospective cohort analysis was conducted. Patients were classified into two groups according to their lactate-to-albumin ratio values: low-lactate-to-albumin ratio (< 0.75) and high-lactate-to-albumin ratio (≥ 0.75). The association between lactate-to-albumin ratio and mortality was evaluated using Cox proportional hazards regression models and restricted cubic spline curves. Receiver operating characteristic curves were employed to assess the diagnostic capability of lactate-to-albumin ratio in predicting prognosis. Additionally, Kaplan-Meier survival analysis was performed to compare the cumulative survival rates between two groups. Subgroup analyses were conducted to validate the robustness of the findings. Conclusion A high lactate-to-albumin ratio (≥ 0.75) at admission was recognized as an independent risk factor for 28-day all-cause mortality in diabetic ketoacidosis patients.