ArticleFrontiers in medicine2026
Developing and validating a lactate-to-albumin ratio-enhanced score for mortality prediction in ICU patients with acute pulmonary embolism: a multi-cohort study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The simplified Pulmonary Embolism Severity Index (sPESI) has limited predictive accuracy for critically ill patients with acute pulmonary embolism (APE) and multi-organ dysfunction and lacks dynamic pathophysiological indicators. This study evaluated the predictive value of the lactate-to-albumin ratio (LAR) for 28-day mortality in ICU patients with APE and explored its potential to optimize the sPESI score. Methods: This study retrospectively analyzed 1098 adult patients with APE in the ICU from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) (derivation cohort, Results: LAR demonstrated a linear relationship with 28-day mortality. The AUC of LAR for predicting mortality was 0.610 in the derivation cohort, 0.710 in the first validation cohort, and 0.647 in the second validation cohort. The LAR-sPESI score showed modest improvements in predictive performance (derivation cohort AUC = 0.650; first validation cohort AUC = 0.733; second validation cohort AUC = 0.701), with acceptable calibration (H-L test, Conclusion: LAR may serve as a preliminary exploratory predictor of 28-day mortality in ICU patients with APE. The LAR-sPESI score yielded only modest numerical gains in predictive performance, supporting exploratory risk stratification.
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