{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:03:40Z","timestamp":1785323020499,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":209,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82302854"],"award-info":[{"award-number":["82302854"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2025M772070"],"award-info":[{"award-number":["2025M772070"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mediators of Inflammation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Congestive heart failure (CHF) among critically ill patients is a significant cardiovascular disorder that is linked to elevated mortality rates. The lactate\/albumin ratio (LAR) is a readily available clinical metric that may provide valuable information regarding the metabolic and nutritional conditions. However, its association with mortality in patients with CHF remains unexplored. This study aimed to investigate the association between LAR and 28\u2010day intensive care unit (ICU) mortality among critically ill patients with CHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the eICU Collaborative Research Database (eICU\u2010CRD), this study was retrospective and observational. The study included those admitted to the ICU with a preliminary CHF diagnosis. The nonlinear relationship between LAR and 28\u2010day mortality was assessed using multivariate Cox regression and generalized additive models (GAMs), with confounders adjusted, and the crucial LAR value was identified through threshold effect analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 2117 patients diagnosed with CHF, 291 (13.7%) died within 28 days of ICU admission. A nonlinear relationship was observed between the LAR and mortality. For LAR values under 1.65, each unit increment was associated with a 2.41\u2010fold increase in the likelihood of mortality (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Nonetheless, this link was not significant for LARs \u2265 1.65 (HR\u2009=\u20091.14,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.111). Subgroup analyses validated the robustness of this nonlinear relationship, except for a significant interaction with the respiratory rate. Mediation analysis revealed that white blood cell (WBC) counts partially mediated the link between LAR and mortality, suggesting potential connections between metabolic disturbances, inflammatory pathways, and adverse outcomes in this population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LAR was nonlinearly related to 28\u2010day ICU mortality, identifying a particular turning point in critically ill patients with CHF. These findings suggest that the LAR, a readily available clinical metric, may help identify high\u2010risk patients with CHF and inform clinical management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/mi\/9374199","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T10:30:35Z","timestamp":1785321035000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nonlinear Relationship Between Lactate\/Albumin Ratio and 28\u2010Day ICU Mortality in Patients With Congestive Heart Failure: Insights Into Inflammatory and Metabolic Interplay"],"prefix":"10.1155","volume":"2026","author":[{"given":"Yitong","family":"Bian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1063-3859","authenticated-orcid":false,"given":"Ling","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6935-0912","authenticated-orcid":false,"given":"Ping","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2026 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure of the European Society of Cardiology (ESC)Developed with the Special Contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski P.","year":"2015","journal-title":"European Heart Journal"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.11.053"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000950"},{"key":"e_1_2_11_4_2","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1002\/ejhf.872","article-title":"Organ Dysfunction, Injury and Failure in Acute Heart Failure: From Pathophysiology to Diagnosis and Management. A Review on Behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)","volume":"19","author":"Harjola V. P.","year":"2017","journal-title":"European Journal of Heart Failure"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000525"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-014-0503-3"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-0896-7"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12964-023-01350-7"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000000223"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1205442"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1451"},{"key":"e_1_2_11_12_2","first-page":"S193","article-title":"Internal and Emergency Medicine","volume":"7","author":"Gatta A.","year":"2012","journal-title":"Hypoalbuminemia"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.5937\/jomb0-42284"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2020.550182"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2023.100897"},{"key":"e_1_2_11_16_2","doi-asserted-by":"crossref","first-page":"2182","DOI":"10.1002\/ehf2.14788","article-title":"Association of Lactate\/Albumin Ratio with 3-Month ReadMission Risk in Heart Failure Patients: A Retrospective Study","volume":"11","author":"Sun H.","year":"2024","journal-title":"ESC Heart Failure"},{"key":"e_1_2_11_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-73788-9"},{"key":"e_1_2_11_18_2","doi-asserted-by":"publisher","DOI":"10.21037\/atm-20-4519"},{"key":"e_1_2_11_19_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.650278"},{"key":"e_1_2_11_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.0000043825.01705.1B"},{"key":"e_1_2_11_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.124.323659"},{"key":"e_1_2_11_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12012-020-09563-9"},{"key":"e_1_2_11_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000024785"},{"key":"e_1_2_11_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/sdata.2018.178"},{"key":"e_1_2_11_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(02)00539-5"},{"key":"e_1_2_11_26_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1804923"},{"key":"e_1_2_11_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2006.01.014"},{"key":"e_1_2_11_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(14)70061-X"},{"key":"e_1_2_11_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/0148607115625638"},{"key":"e_1_2_11_30_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu16244401"},{"key":"e_1_2_11_31_2","doi-asserted-by":"crossref","first-page":"2309","DOI":"10.1056\/NEJMra1309483","article-title":"Lactic Acidosis","volume":"371","author":"Kraut J. 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