Clinical value of the lactate-to-albumin ratio in assessing prognosis in critically ill patients with sepsis-associated encephalopathy: A retrospective analysis.

ObjectiveSepsis-associated encephalopathy (SAE) is a critical complication of sepsis with high mortality, yet reliable prognostic biomarkers remain limited. This study aimed to investigate the association between the lactate-to-albumin ratio (LAR) and short- and long-term mortality in SAE patients.MethodsA retrospective cohort analysis was conducted using the MIMIC-IV database, including 874 adult SAE patients. LAR was calculated within 24 h of ICU admission. Participants were stratified into quartiles (Q1-Q4) based on LAR values. Cox proportional hazards models and restricted cubic spline (RCS) were employed to evaluate relationships between LAR and mortality at 30, 90, 180, and 365 days. The area under the receiver operating characteristic (ROC) curve (AUC) was employed to evaluate the predictive performance of LAR.ResultsKaplan-Meier analysis demonstrated that, the Q2,Q3,Q4 group experienced significantly lower survival rate compared to the Q1 group for 30-day, 90-day, 180-day, and 365-day, with the Q4 group had the lowest survival rate. Cox proportional hazards regression revealed LAR as a robust independent predictor, demonstrating persistent prognostic significance across all observed time points. RCS analysis revealed a nonlinear association between LAR and the mortality of SAE. The ROC curves demonstrated robust predictive ability of LAR, with AUCs of 0.753 (30-day), 0.736 (90-day), 0.733 (180-day), and 0.725 (365-day).ConclusionsLAR serves as an easily accessible, independent prognostic biomarker for predicting short- and long-term mortality in SAE patients, exhibiting a distinct nonlinear correlation with mortality risks over these periods. These results underscore its potential value in risk stratification and in guiding early clinical interventions. Additional prospective studies are needed to confirm its role in the management of SAE.