术前乳酸与白蛋白比值与老年人心脏手术后术后谵妄风险：一项回顾性队列研究
Preoperative lactate-to-albumin ratio and risk of postoperative delirium after cardiac surgery in older adults: a retrospective cohort study.
摘要(中文译文)
乳酸与白蛋白比值（LAR）与接受心脏手术的老年患者术后谵妄（POD）之间的关联尚不明确。本研究旨在探讨该人群中术前LAR与POD之间的关联。研究对象选自医疗信息重症监护数据库第四版（MIMIC-IV）。术前7天内获取的乳酸和白蛋白值用于计算LAR。主要终点为术后7天内发生的POD。采用Cox比例风险模型、限制性立方样条、敏感性分析和Kaplan-Meier分析评估LAR与POD之间的关联。共纳入2,021例患者，其中271例（13.41%）发生POD。在主要校正模型中，较高的LAR与较高的POD风险相关（HR 1.649，95% CI 1.367-1.990，p < 0.001）。与低LAR组相比，中和高LAR组的POD风险更高（HR 1.561，95% CI 1.157-2.106；HR 2.403，95% CI 1.754-3.293）。该关联在敏感性分析中持续存在。限制性立方样条分析提示较高的LAR与POD风险增加之间呈线性关系。研究结果表明，术前LAR升高与接受心脏手术的老年患者POD风险增加相关。LAR可能是一种简便实用的术前风险分层指标。
Abstract
The association between the lactate-to-albumin ratio (LAR) and postoperative delirium (POD) in older adults undergoing cardiac surgery remains uncertain. This study aimed to explore the association between preoperative LAR and POD in this population. Participants were selected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Preoperative lactate and albumin values obtained within 7 days before surgery were used to calculate LAR. The primary endpoint was POD within 7 days after surgery. Cox proportional hazards models, restricted cubic splines, sensitivity analysis, and Kaplan-Meier analysis were used to assess the association between LAR and POD. A total of 2,021 patients were included, and 271 (13.41%) developed POD. In the main adjusted model, higher LAR was associated with a higher hazard of POD (HR 1.649, 95% CI 1.367-1.990, p < 0.001). Compared with the low LAR group, the medium and high LAR groups had higher hazards of POD (HR 1.561, 95% CI 1.157-2.106; HR 2.403, 95% CI 1.754-3.293, respectively). This association persisted in sensitivity analysis. Restricted cubic spline analysis suggested a linear relationship between higher LAR and increased POD risk. The study findings indicate that elevated preoperative LAR is associated with increased POD risk in older adults undergoing cardiac surgery. LAR may be a simple and practical marker for preoperative risk stratification.
如何引用
AMA
Bingfa Pan, Yanwen Song, He Li, Jian Wang, Ping Chen, Shuhan Yang, et al. Preoperative lactate-to-albumin ratio and risk of postoperative delirium after cardiac surgery in older adults: a retrospective cohort study.. BMC cardiovascular disorders. 2026; doi:10.1186/s12872-026-05946-y.
APA
Bingfa Pan, Yanwen Song, He Li, Jian Wang, Ping Chen, Shuhan Yang, et al (2026). Preoperative lactate-to-albumin ratio and risk of postoperative delirium after cardiac surgery in older adults: a retrospective cohort study.. BMC cardiovascular disorders. https://doi.org/10.1186/s12872-026-05946-y
GB/T 7714
Bingfa Pan, Yanwen Song, He Li, Jian Wang, Ping Chen, Shuhan Yang, et al. Preoperative lactate-to-albumin ratio and risk of postoperative delirium after cardiac surgery in older adults: a retrospective cohort study.[J]. BMC cardiovascular disorders, 2026 doi:10.1186/s12872-026-05946-y.
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