Research Article
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The Effect of Lactate Dehydrogenase/Albumin Ratio on the Clinical Progress in Patients with Lower Respiratory Tract Infection

Year 2025, Volume: 9 Issue: 2, 128 - 134, 08.08.2025
https://doi.org/10.46332/aemj.1499231

Abstract

Purpose: We aimed to explore the impact of the lactate dehydrogenase to albumin (LDH/ALB) ratio, an independent indicator of prognosis associated with the clinical course and mortality in lower respiratory tract infections (LRTI).

Materials and Methods: This study included patients aged 18 to 90 who presented to the emergency department or pulmonology outpatient clinic of a training and research hospital between December 2021 and January 2023 and were admitted to the pulmonology ward or intensive care unit with a diagnosis of lower respiratory tract infection (LRTI). The data from the patients' initial admission whether through the emergency department, pulmonology outpatient clinic, pulmonology ward, or ICU were evaluated for inclusion in the study.

Results: A total of 200 patients were included in the study. The LDH/ALB ratios were significantly higher in deceased (ex) patients compared to survivors (p<0.001). In the ROC curve analysis for mortality prediction, the LDH/ALB ratio demonstrated a strong predictive value, with an area under the curve (AUC) of 0.801 (p<0.001).

Conclusion: LDH/ALB ratio may be an independent prognostic ındıcator for in-hospital mortality and ICU hospitalization decision in patients with LRTI.

Project Number

162.20.06

References

  • 1. Lee BK, Ryu S, Oh SK, et al. Lactate dehydrogenase to albumin ratio as a prognostic factor in lower respiratory tract infection patients. Am J Emerg Med. 2022;52:54-58.
  • 2. Ewig S, Bauer T, Hasper, E et al. Prognostic analysis and predictive rule for outcome of hospital-treated community-acquired pneumonia. Eur Respir J. 1995;8(3):392-397.
  • 3. Xu Y, Yang H, Wang J, et al. Serum Albumin Levels are a Predictor of COVID-19 Patient Prognosis: Evidence from a Single Cohort in Chongqing, China. Int J Gen Med. 2021;24(14):2785-2797.
  • 4. Fernandez P, Torres A, Miro JM, et al. Prognostic factors influencing the outcome in pneumocystis carinii pneumonia in patients with AIDS. Thorax. 1995;50 (6):668-671.
  • 5. Shokr H, Marwah MK, Siddiqi H, et al. Lactate Dehydrogenase/Albumin To-Urea Ratio: A Novel Prognostic Maker for Fatal Clinical Complications in Patients with COVID-19 Infection. J Clin Med. 2022;12(1):19.
  • 6. Lu J, Wei Z, Jiang H, et al. Lactate dehydrogenase is associated with 28-day mortality in patients with sepsis: a retrospective observational study. J Surg Res. 2018;228:314-321.
  • 7. Hespanhol V, Bárbara C. Pneumonia mortality, comorbidities matter? Authors' answer. Pulmonology. 2021;27(1):85-86.
  • 8. Baek MS, Park S, Choi JH, et al. Mortality and Prognostic Prediction in Very Elderly Patients With Severe Pneumonia. J Intensive Care Med. 2020;35(12):1405-1410.
  • 9. İmre, O, Caglayan C, Muştu M. The Relationship of Cognitive Dysfunction with Inflammatory Markers and Carotid Intima Media Thickness in Schizophrenia. J. Pers. Med. 2023;13(9):1342.
  • 10. Luo X, Yang X, Li J, et al. The procalcitonin/albumin ratio as an early diagnostic predictor in discriminating urosepsis from patients with febrile urinary tract infection. Medicine (Baltimore). 2018;97(28):11078.
  • 11. Shin J, Hwang SY, Jo IJ, et al. Prognostic Value of The Lactate/Albumin Ratio for Predicting 28-Day Mortality in Critically ILL Sepsis Patients. Shock. 2018;50(5):545-550.
  • 12. Gong Y, Li D, Cheng B, et al. Increased neutrophil percentage-to-albumin ratio is associated with all-cause mortality in patients with severe sepsis or septic shock. Epidemiol Infect. 2020;148:87.
  • 13. Deng S, Gao J, Zhao Z, et al. Albumin/Procalcitonin Ratio Is a Sensitive Early Marker of Nosocomial Blood Stream Infection in Patients with Intra-Cerebral Hemorrhage. Surg Infect (Larchmt). 2019;20(8):643-649.
  • 14. Aday U, Tatlı F, Akpulat FV, et al. Prognostic significance of pretreatment serum lactate dehydrogenase-to-albumin ratio in gastric cancer. Contemp Oncol (Pozn). 2020;24(3):145-149.
  • 15. Feng JF, Wang L, Yang X, et al. Prognostic value of lactate dehydrogenase to albumin ratio (LAR) in patients with resectable esophageal squamous cell carcinoma. Cancer Manag Res. 2019;11:7243-7251.
  • 16. Luna CM, Perín MM. Can lactate dehydrogenase (LDH) be used as a marker of severity of pneumonia in patients with renal transplant? Ann Transl Med. 2020;8(15):911.
  • 17. Su Y, Ju MJ, Ma JF, et al. Lactate dehydrogenase as a prognostic marker of renal transplant recipients with severe community-acquired pneumonia: a 10-year retrospective study. Ann Transl Med. 2019;7(22):660.
  • 18. Cekic D, Issever K, Genc AC, et al. Association of C-reactive Protein/Albumin, Procalcitonin/Albumin, Platelet/Lymphocyte, and Lymphocyte/Monocyte Ratio with Mortality in Hospitalised COVID-19 Patients. J Coll Physicians Surg Pak. 2022;32(9):1191-1195.

Alt Solunum Yolu Enfeksiyonu Tanılı Hastalarda Laktat Dehidrogenaz/Albumin Oranının Klinik Seyir Üzerine Etkisi

Year 2025, Volume: 9 Issue: 2, 128 - 134, 08.08.2025
https://doi.org/10.46332/aemj.1499231

Abstract

Amaç: Alt solunum yolu enfeksiyonlarında (ASYE) klinik seyir, mortalite ile ilişkili bağımsız bir prognostik faktör olan laktat dehidrogenaz/albümin (LDH/ALB) oranının etkisinin araştırılması amaçlandı.

Araçlar ve Yöntem:Bu çalışmaya 18-90 yaş arası üçüncü basamak eğitim ve araştırma hastanesi acil servis veya göğüs hastalıkları polikliniğine Aralık 2021 ile Ocak 2023 tarihleri arasında başvuran ve ASYE tanısı ile göğüs hastalıkları servis veya yoğun bakıma yatışı yapılan hastalar dahil edilmiştir.Hastaların acil servis, göğüs hastalıkları polikliniği, göğüs hastalıkları servis veya yoğun bakıma yatış verilerinden ilk başvuru verileri çalışmaya dahil edilmek üzere değerlendirildi.

Bulgular: Çalışmaya toplam 200 hasta alındı.Ex olan hastaların LDH/ALB oranı değerleri ex olmayan hastalara kıyasla istatistiksel açıdan anlamlı olarak yüksekti(p<0.001). Ex durumu için çizilen ROC eğrisinde LDH/ALB oranı (AUC=0.801 ; p<0.001) AUC’si mortalitenin daha güçlü belirleyicisi olarak saptandı.

Sonuç:LDH/ALB oranı ASYE tanılı hastalarda hastane içi mortalite ve yoğunbakım yatışı kararı için bağımsız bir prognostik faktör olabilir.

Project Number

162.20.06

References

  • 1. Lee BK, Ryu S, Oh SK, et al. Lactate dehydrogenase to albumin ratio as a prognostic factor in lower respiratory tract infection patients. Am J Emerg Med. 2022;52:54-58.
  • 2. Ewig S, Bauer T, Hasper, E et al. Prognostic analysis and predictive rule for outcome of hospital-treated community-acquired pneumonia. Eur Respir J. 1995;8(3):392-397.
  • 3. Xu Y, Yang H, Wang J, et al. Serum Albumin Levels are a Predictor of COVID-19 Patient Prognosis: Evidence from a Single Cohort in Chongqing, China. Int J Gen Med. 2021;24(14):2785-2797.
  • 4. Fernandez P, Torres A, Miro JM, et al. Prognostic factors influencing the outcome in pneumocystis carinii pneumonia in patients with AIDS. Thorax. 1995;50 (6):668-671.
  • 5. Shokr H, Marwah MK, Siddiqi H, et al. Lactate Dehydrogenase/Albumin To-Urea Ratio: A Novel Prognostic Maker for Fatal Clinical Complications in Patients with COVID-19 Infection. J Clin Med. 2022;12(1):19.
  • 6. Lu J, Wei Z, Jiang H, et al. Lactate dehydrogenase is associated with 28-day mortality in patients with sepsis: a retrospective observational study. J Surg Res. 2018;228:314-321.
  • 7. Hespanhol V, Bárbara C. Pneumonia mortality, comorbidities matter? Authors' answer. Pulmonology. 2021;27(1):85-86.
  • 8. Baek MS, Park S, Choi JH, et al. Mortality and Prognostic Prediction in Very Elderly Patients With Severe Pneumonia. J Intensive Care Med. 2020;35(12):1405-1410.
  • 9. İmre, O, Caglayan C, Muştu M. The Relationship of Cognitive Dysfunction with Inflammatory Markers and Carotid Intima Media Thickness in Schizophrenia. J. Pers. Med. 2023;13(9):1342.
  • 10. Luo X, Yang X, Li J, et al. The procalcitonin/albumin ratio as an early diagnostic predictor in discriminating urosepsis from patients with febrile urinary tract infection. Medicine (Baltimore). 2018;97(28):11078.
  • 11. Shin J, Hwang SY, Jo IJ, et al. Prognostic Value of The Lactate/Albumin Ratio for Predicting 28-Day Mortality in Critically ILL Sepsis Patients. Shock. 2018;50(5):545-550.
  • 12. Gong Y, Li D, Cheng B, et al. Increased neutrophil percentage-to-albumin ratio is associated with all-cause mortality in patients with severe sepsis or septic shock. Epidemiol Infect. 2020;148:87.
  • 13. Deng S, Gao J, Zhao Z, et al. Albumin/Procalcitonin Ratio Is a Sensitive Early Marker of Nosocomial Blood Stream Infection in Patients with Intra-Cerebral Hemorrhage. Surg Infect (Larchmt). 2019;20(8):643-649.
  • 14. Aday U, Tatlı F, Akpulat FV, et al. Prognostic significance of pretreatment serum lactate dehydrogenase-to-albumin ratio in gastric cancer. Contemp Oncol (Pozn). 2020;24(3):145-149.
  • 15. Feng JF, Wang L, Yang X, et al. Prognostic value of lactate dehydrogenase to albumin ratio (LAR) in patients with resectable esophageal squamous cell carcinoma. Cancer Manag Res. 2019;11:7243-7251.
  • 16. Luna CM, Perín MM. Can lactate dehydrogenase (LDH) be used as a marker of severity of pneumonia in patients with renal transplant? Ann Transl Med. 2020;8(15):911.
  • 17. Su Y, Ju MJ, Ma JF, et al. Lactate dehydrogenase as a prognostic marker of renal transplant recipients with severe community-acquired pneumonia: a 10-year retrospective study. Ann Transl Med. 2019;7(22):660.
  • 18. Cekic D, Issever K, Genc AC, et al. Association of C-reactive Protein/Albumin, Procalcitonin/Albumin, Platelet/Lymphocyte, and Lymphocyte/Monocyte Ratio with Mortality in Hospitalised COVID-19 Patients. J Coll Physicians Surg Pak. 2022;32(9):1191-1195.
There are 18 citations in total.

Details

Primary Language English
Subjects Chest Diseases
Journal Section Research Article
Authors

Yaşar İncekara 0000-0002-1430-1571

Selda Aslan 0000-0001-8695-7118

Project Number 162.20.06
Submission Date June 10, 2024
Acceptance Date January 2, 2025
Early Pub Date August 1, 2025
Publication Date August 8, 2025
Published in Issue Year 2025 Volume: 9 Issue: 2

Cite

APA İncekara, Y., & Aslan, S. (2025). The Effect of Lactate Dehydrogenase/Albumin Ratio on the Clinical Progress in Patients with Lower Respiratory Tract Infection. Ahi Evran Medical Journal, 9(2), 128-134. https://doi.org/10.46332/aemj.1499231
AMA İncekara Y, Aslan S. The Effect of Lactate Dehydrogenase/Albumin Ratio on the Clinical Progress in Patients with Lower Respiratory Tract Infection. Ahi Evran Med J. August 2025;9(2):128-134. doi:10.46332/aemj.1499231
Chicago İncekara, Yaşar, and Selda Aslan. “The Effect of Lactate Dehydrogenase Albumin Ratio on the Clinical Progress in Patients With Lower Respiratory Tract Infection”. Ahi Evran Medical Journal 9, no. 2 (August 2025): 128-34. https://doi.org/10.46332/aemj.1499231.
EndNote İncekara Y, Aslan S (August 1, 2025) The Effect of Lactate Dehydrogenase/Albumin Ratio on the Clinical Progress in Patients with Lower Respiratory Tract Infection. Ahi Evran Medical Journal 9 2 128–134.
IEEE Y. İncekara and S. Aslan, “The Effect of Lactate Dehydrogenase/Albumin Ratio on the Clinical Progress in Patients with Lower Respiratory Tract Infection”, Ahi Evran Med J, vol. 9, no. 2, pp. 128–134, 2025, doi: 10.46332/aemj.1499231.
ISNAD İncekara, Yaşar - Aslan, Selda. “The Effect of Lactate Dehydrogenase Albumin Ratio on the Clinical Progress in Patients With Lower Respiratory Tract Infection”. Ahi Evran Medical Journal 9/2 (August2025), 128-134. https://doi.org/10.46332/aemj.1499231.
JAMA İncekara Y, Aslan S. The Effect of Lactate Dehydrogenase/Albumin Ratio on the Clinical Progress in Patients with Lower Respiratory Tract Infection. Ahi Evran Med J. 2025;9:128–134.
MLA İncekara, Yaşar and Selda Aslan. “The Effect of Lactate Dehydrogenase Albumin Ratio on the Clinical Progress in Patients With Lower Respiratory Tract Infection”. Ahi Evran Medical Journal, vol. 9, no. 2, 2025, pp. 128-34, doi:10.46332/aemj.1499231.
Vancouver İncekara Y, Aslan S. The Effect of Lactate Dehydrogenase/Albumin Ratio on the Clinical Progress in Patients with Lower Respiratory Tract Infection. Ahi Evran Med J. 2025;9(2):128-34.

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