Association between lactic dehydrogenase-to-albumin ratio and all-cause mortality in critical obstructive sleep apnea patients: a retrospective cohort study from the MIMIC-IV database.
9 affiliations
- 1Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600 Yishan Road, Shanghai, 200233, China.
- 2Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, 200233, China.
- 3Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, 200233, China.
- 4Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600 Yishan Road, Shanghai, 200233, China. [email protected].
- 5Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, 200233, China. [email protected].
- 6Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, 200233, China. [email protected].
- 7Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600 Yishan Road, Shanghai, 200233, China. [email protected].
- 8Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, 200233, China. [email protected].
- 9Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, 200233, China. [email protected].
Abstract
Objectives
Our study endeavors to elucidate the link of the lactic dehydrogenase-to-albumin ratio (LDAR) to all-cause mortality (ACM) among the critically ill obstructive sleep apnea (OSA) population.Methods
A retrospective observational cohort study was performed leveraging the MIMIC-IV 3.1 data. This study encompassed adult OSA patients first entering the intensive care unit (ICU). Patients were stratified into quartiles by LDAR. The primary outcomes were ACM at 30, 90, 180 days, and one year after ICU entry. ACM across LDAR quartiles was compared via the Kaplan-Meier (KM) survival analysis. The relation of LDAR to ACM was examined utilizing multivariable Cox proportional hazards regression and restricted cubic spline (RCS) models. The consistency and robustness of our findings were rated through subgroup, interaction, and sensitivity analyses.Results
One thousand one hundred eighteen critically ill OSA patients were encompassed. 749 (66.99%) were male, with a median age of 66. The 30-day, 90-day, 180-day, and one-year ACM rates were 14.58%, 19.59%, 22.00%, and 26.74%. KM curves demonstrated significantly higher mortality rates across increasing LDAR quartiles (log-rank P < 0.001). After possible confounders were adjusted, LDAR was independently related to elevated 90-day ACM risk (HR, 1.318; 95%CI, 1.142-1.520) as a continuous variable. In contrast to the lowest LDAR quartile, the highest quartile displayed a 139.8% greater likelihood of 90-day ACM (HR, 2.398; 95%CI, 1.512-3.803; Ptrend < 0.001). Similar relations were noted for 30-day, 180-day, and one-year ACM. RCS analysis revealed a positive linear relation of LDAR to death at all time points (Pnonlinear > 0.05). Subgroup and interaction analyses revealed insignificant effect modification, confirming the robustness of the association across various clinical strata.Conclusion
Among the critically ill OSA population, elevated LDAR is independently and linearly related to elevated ACM risk in short-term and long-term mortality. The foregoing findings suggest LDAR as a valuable prognostic biomarker for risk classification and clinical management among this high-risk population.
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BibTeX
@article{zhou2026association,
title = {{Association between lactic dehydrogenase-to-albumin ratio and all-cause mortality in critical obstructive sleep apnea patients: a retrospective cohort study from the MIMIC-IV database.}},
author = {Enhui Zhou and Fan Song and Chenyang Li and Jingyu Zhang and Tianjiao Zhou and Weijun Huang and Hongliang Yi},
journal = {BMC pulmonary medicine},
year = {2026},
month = aug,
doi = {10.1186/s12890-026-04537-z},
url = {https://europepmc.org/article/MED/42958154},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Association between lactic dehydrogenase-to-albumin ratio and all-cause mortality in critical obstructive sleep apnea patients: a retrospective cohort study from the MIMIC-IV database.
AU - Enhui Zhou
AU - Fan Song
AU - Chenyang Li
AU - Jingyu Zhang
AU - Tianjiao Zhou
AU - Weijun Huang
AU - Hongliang Yi
PY - 2026
DA - 2026/08/01
JO - BMC pulmonary medicine
DO - 10.1186/s12890-026-04537-z
UR - https://europepmc.org/article/MED/42958154
AB - Objectives Our study endeavors to elucidate the link of the lactic dehydrogenase-to-albumin ratio (LDAR) to all-cause mortality (ACM) among the critically ill obstructive sleep apnea (OSA) population.Methods A retrospective observational cohort study was performed leveraging the MIMIC-IV 3.1 data. This study encompassed adult OSA patients first entering the intensive care unit (ICU). Patients were stratified into quartiles by LDAR. The primary outcomes were ACM at 30, 90, 180 days, and one year after ICU entry. ACM across LDAR quartiles was compared via the Kaplan-Meier (KM) survival analysis. The relation of LDAR to ACM was examined utilizing multivariable Cox proportional hazards regression and restricted cubic spline (RCS) models. The consistency and robustness of our findings were rated through subgroup, interaction, and sensitivity analyses.Results One thousand one hundred eighteen critically ill OSA patients were encompassed. 749 (66.99%) were male, with a median age of 66. The 30-day, 90-day, 180-day, and one-year ACM rates were 14.58%, 19.59%, 22.00%, and 26.74%. KM curves demonstrated significantly higher mortality rates across increasing LDAR quartiles (log-rank P < 0.001). After possible confounders were adjusted, LDAR was independently related to elevated 90-day ACM risk (HR, 1.318; 95%CI, 1.142-1.520) as a continuous variable. In contrast to the lowest LDAR quartile, the highest quartile displayed a 139.8% greater likelihood of 90-day ACM (HR, 2.398; 95%CI, 1.512-3.803; Ptrend < 0.001). Similar relations were noted for 30-day, 180-day, and one-year ACM. RCS analysis revealed a positive linear relation of LDAR to death at all time points (Pnonlinear > 0.05). Subgroup and interaction analyses revealed insignificant effect modification, confirming the robustness of the association across various clinical strata.Conclusion Among the critically ill OSA population, elevated LDAR is independently and linearly related to elevated ACM risk in short-term and long-term mortality. The foregoing findings suggest LDAR as a valuable prognostic biomarker for risk classification and clinical management among this high-risk population.
SN - 1471-2466
ER -