Alimentary Pharmacology & Therapeutics, Год журнала: 2024, Номер 61(1), С. 4 - 5
Опубликована: Дек. 12, 2024
Язык: Английский
BMC Infectious Diseases, Год журнала: 2025, Номер 25(1)
Опубликована: Фев. 14, 2025
Patients with liver cirrhosis face high infection risks due to immune dysfunction and hospital-related factors, increasing mortality rates when sepsis occurs. While various biomarkers predict outcomes in cirrhosis, few are accessible reliable. This study addresses the gap by evaluating prognostic potential of lactate-to-albumin ratio (LAR). We retrospectively analyzed data from patients who were admitted intensive care unit at Beth Israel Deaconess Medical Center between 2008 2022. LAR was calculated obtained first measurement taken within 24 h admission. The optimal threshold determined using R statistical software. Kaplan-Meier analysis used compare two patient groups, while multivariate Cox proportional hazards regression models assess association risk concomitant sepsis. A restricted cubic spline (RCS) explore dose-response relationships mortality. Receiver operating characteristic (ROC) analyses predictive ability, sensitivity, specificity for all-cause combined sepsis, area under curve (AUC) calculated. Finally, subgroup performed relationship prognosis across different populations. total 1731 included study. identified as 1.0 indicated that higher levels had a 14-day, 28-day, 90-day (all log-rank P < 0.001). Multivariate independent associations before after adjusting confounders. RCS revealed nonlinear short- long-term ROC showed although value slightly inferior Model End-Stage Liver Disease score, it significantly better than lactate, albumin, Sequential Organ Failure Assessment. Subgroup no significant interactions any specific subgroup. has good
Язык: Английский
Процитировано
2
BMC Gastroenterology, Год журнала: 2025, Номер 25(1)
Опубликована: Фев. 24, 2025
The impact of lactate-to-albumin ratio (LAR) on mortality critically ill cirrhotic patients with sepsis is scant. Critically were obtained from the MIMIC-IV database (v3.0). Cox regression models alone and in combination restricted cubic splines, generalized additive smoothed curve fitting used to investigate relationship between LAR all-cause mortality. A total 1864 included. 30-day, 90-day, 180-day rates 38.0%, 46.3%, 49.5%, respectively. Higher significantly nonlinearly associated higher risks (all adjusted HR = 1.17, P < 0.001). L-shaped associations observed, an inflection point 1.05 (P for log-likelihood 0.01). Compared 1.05, ≥ had (adjusted (95% CI): 1.48 (1.27–1.72), 1.44 (1.25–1.66), 1.38 (1.21–1.57), respectively). No potential modifiers found was positively sepsis. Thus, it could be as a prognostic biomarker.
Язык: Английский
Процитировано
0
Pharmaceuticals, Год журнала: 2025, Номер 18(3), С. 339 - 339
Опубликована: Фев. 27, 2025
Ascites is the most common complication from cirrhosis related to portal hypertension and depicts onset of hepatic decompensation. Ranging uncomplicated refractory ascites, progression carries prognostic value by reflecting deterioration underlying hypertension. Diuretics have been mainstay treatment control but side effects heighten when dosage escalated. Non-selective beta-blockers (NSBBs) are widely used nowadays prevent decompensation variceal hemorrhage. However, with worsening systemic vasodilation inflammation ascites progresses, patients on NSBBs at risk hemodynamic collapse leading renal hypoperfusion thus hepatorenal syndrome. Long-term albumin infusion was studied ascites. results were conflicting. Sodium-glucose cotransporter-2 inhibitors under investigation With that, may require regular large-volume paracentesis. an aging population, more put anti-thrombotic agents their risks in decompensated invasive procedures be considered. In general, poses multiple issues pharmacological treatment. present review, we discuss challenges controversies
Язык: Английский
Процитировано
0
Alimentary Pharmacology & Therapeutics, Год журнала: 2024, Номер 61(1), С. 4 - 5
Опубликована: Дек. 12, 2024
Язык: Английский
Процитировано
0