Infect Drug Resist. 2026 Jun 24;19:585882. doi: 10.2147/IDR.S585882. eCollection 2026.
ABSTRACT
PURPOSE: Although albumin-based indices have prognostic value in older adults with community-acquired pneumonia (CAP), the predictive role of lactate dehydrogenase to albumin ratio (LAR) remains insufficiently explored. This study aimed to evaluate LAR as a predictor of CAP severity in patients aged ≥60 years.
PATIENTS AND METHODS: We conducted a retrospective cohort study of patients aged ≥60 years with CAP hospitalized from June 2022 to June 2025 at six secondary and tertiary academic hospitals in China. By stratifying patient into tertiles, we assessed the correlation between LAR and the severity of CAP. To explore the association between LAR and CAP severity, we employed logistic regression analyses, and subgroup analyses based on demographics and comorbidities to validate the robustness of our findings.
RESULTS: A total of 423 patients with CAP were included, of which 102 cases (24.1%) were severe community-acquired pneumonia (SCAP). The average age of the participants was 73.2±7.5 years, with 64.8% being male. Natural logarithm (ln) transformed LAR on admission was significantly linked to the severity of CAP in the unadjusted analysis [Odds Ratio (OR) 23.24; 95% Confidence Interval (CI) 12.09-44.69]. Following controlling for potential variables, the association remained statistically significant (OR 11.41; 95% CI 3.57-36.47). When ln transformed LAR was categorized into tertiles, the severity of CAP in the highest tertile (T3) was significantly higher compared to that in the lowest tertile (T1) (model 4: OR = 9.43, 95% CI: 2.22-39.97). Subgroup analyses supported the stability of these findings.
CONCLUSION: LAR may serve as a promising predictor of the severity of CAP and may assist clinicians in identifying high-risk individuals among CAP patients. Future research is warranted to further validate the predictive utility of LAR in different populations and investigate its potential applications in CAP management.
PMID:42371587 | PMC:PMC13310506 | DOI:10.2147/IDR.S585882
