# 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

## TL;DR

This study found that a high lactate-to-albumin ratio at hospital admission is linked to higher 28-day mortality in patients with diabetic ketoacidosis.

## Contribution

The study identifies the lactate-to-albumin ratio as a novel predictor of mortality in diabetic ketoacidosis patients.

## Key findings

- A high lactate-to-albumin ratio (≥ 0.75) is an independent risk factor for 28-day all-cause mortality in diabetic ketoacidosis patients.
- The lactate-to-albumin ratio shows strong prognostic value for predicting mortality in this patient group.
- Kaplan-Meier survival analysis confirmed lower survival rates in patients with a high lactate-to-albumin ratio.

## Abstract

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.

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.

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.