{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T15:25:49Z","timestamp":1787930749874,"version":"build-2784847793"},"reference-count":29,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_med-2026-1511_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Acute pancreatitis (AP) carries a high mortality risk in ICU patients. The glucose-to-albumin ratio (GAR), reflecting metabolic stress and albumin status, may serve as a simple prognostic marker. This study evaluated the association between GAR and mortality in ICU patients with\u00a0AP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2026-1511_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 754 ICU patients with AP from the MIMIC-IV database were analyzed. Patients were divided into quartiles based on GAR. Multivariable Cox regression, Kaplan-Meier survival analysis, Boruta algorithm, and machine learning models were used to assess the relationship between GAR and 30-day and 90-day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2026-1511_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Elevated GAR was independently associated with increased mortality risk. For 30-day mortality, GAR had the highest AUC (0.69) compared to albumin, SOFA, and glucose. Patients in the highest GAR quartile had a 10.2-fold increased risk of 30-day mortality (p&lt;0.001). The\u00a0Boruta algorithm identified GAR as an important predictor, and LightGBM showed the best performance (AUC=0.83).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2026-1511_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GAR was independently associated with 30-day and 90-day mortality in ICU patients with AP. As a simple and readily available biomarker, GAR may help improve early mortality risk stratification in this critically ill population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/med-2026-1511","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:56:51Z","timestamp":1787929011000},"source":"Crossref","is-referenced-by-count":0,"title":["Glucose-to-albumin ratio and mortality in ICU patients with acute pancreatitis"],"prefix":"10.1515","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6245-242X","authenticated-orcid":false,"given":"Qingqing","family":"Xiao","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine , The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9135-7923","authenticated-orcid":false,"given":"Siwen","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Blood Transfusion , The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"2026082814564535076_j_med-2026-1511_ref_001","doi-asserted-by":"crossref","unstructured":"G\u0142uszek, S, Adamus-Bia\u0142ek, W, Chrapek, M, Dziuba, A, Dul\u0119bska, J, Kozie\u0142, D, et al.. Genetic variability in the CPA1 gene and its impact on acute pancreatitis risk: new insights from a large-scale study. Int J Mol Sci 2024;25:11301. https:\/\/doi.org\/10.3390\/ijms252011301.","DOI":"10.3390\/ijms252011301"},{"key":"2026082814564535076_j_med-2026-1511_ref_002","doi-asserted-by":"crossref","unstructured":"Yang, Y, Guo, C, Gu, Z, Hua, J, Zhang, J, Qian, S, et al.. The global burden of appendicitis in 204 countries and territories from 1990 to 2019. Clin Epidemiol 2022;14:1487\u201399. https:\/\/doi.org\/10.2147\/clep.S376665.","DOI":"10.2147\/CLEP.S376665"},{"key":"2026082814564535076_j_med-2026-1511_ref_003","doi-asserted-by":"crossref","unstructured":"Glaubitz, J, Asgarbeik, S, Lange, R, Mazloum, H, Elsheikh, H, Weiss, FU, et al.. Immune response mechanisms in acute and chronic pancreatitis: strategies for therapeutic intervention. Front Immunol 2023;14:1279539. https:\/\/doi.org\/10.3389\/fimmu.2023.1279539.","DOI":"10.3389\/fimmu.2023.1279539"},{"key":"2026082814564535076_j_med-2026-1511_ref_004","doi-asserted-by":"crossref","unstructured":"Baron, TH, DiMaio, CJ, Wang, AY, Morgan, KA. American Gastroenterological Association clinical practice update: management of pancreatic necrosis. Gastroenterology 2020;158:67\u201375.e1. https:\/\/doi.org\/10.1053\/j.gastro.2019.07.064.","DOI":"10.1053\/j.gastro.2019.07.064"},{"key":"2026082814564535076_j_med-2026-1511_ref_005","doi-asserted-by":"crossref","unstructured":"Vege, SS, DiMagno, MJ, Forsmark, CE, Martel, M, Barkun, AN. Initial medical treatment of acute pancreatitis: American Gastroenterological Association Institute technical review. Gastroenterology 2018;154:1103\u201339. https:\/\/doi.org\/10.1053\/j.gastro.2018.01.031.","DOI":"10.1053\/j.gastro.2018.01.031"},{"key":"2026082814564535076_j_med-2026-1511_ref_006","doi-asserted-by":"crossref","unstructured":"Schepers, NJ, Bakker, OJ, Besselink, MG, Ahmed Ali, U, Bollen, TL, Gooszen, HG, et al.. Impact of characteristics of organ failure and infected necrosis on mortality in necrotising pancreatitis. Gut 2019;68:1044\u201351. https:\/\/doi.org\/10.1136\/gutjnl-2017-314657.","DOI":"10.1136\/gutjnl-2017-314657"},{"key":"2026082814564535076_j_med-2026-1511_ref_007","doi-asserted-by":"crossref","unstructured":"Liu, Q, Zheng, HL, Wu, MM, Wang, QZ, Yan, SJ, Wang, M, et al.. Association between lactate-to-albumin ratio and 28-days all-cause mortality in patients with acute pancreatitis: a retrospective analysis of the MIMIC-IV database. Front Immunol 2022;13:1076121. https:\/\/doi.org\/10.3389\/fimmu.2022.1076121.","DOI":"10.3389\/fimmu.2022.1076121"},{"key":"2026082814564535076_j_med-2026-1511_ref_008","doi-asserted-by":"crossref","unstructured":"O\u2019Connell, RM, Boland, MR, O\u2019Driscoll, J, Salih, A, Arumugasamy, M, Walsh, TN, et al.. Red cell distribution width and neutrophil to lymphocyte ratio as predictors of outcomes in acute pancreatitis: a retrospective cohort study. Int J Surg 2018;55:124\u20137. https:\/\/doi.org\/10.1016\/j.ijsu.2018.05.028.","DOI":"10.1016\/j.ijsu.2018.05.028"},{"key":"2026082814564535076_j_med-2026-1511_ref_009","doi-asserted-by":"crossref","unstructured":"Cho, SK, Jung, S, Lee, KJ, Kim, JW. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can predict the severity of gallstone pancreatitis. 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BMC Med Inf Decis Making 2024;24:235. https:\/\/doi.org\/10.1186\/s12911-024-02640-x.","DOI":"10.1186\/s12911-024-02640-x"},{"key":"2026082814564535076_j_med-2026-1511_ref_025","doi-asserted-by":"crossref","unstructured":"Kothari, A, Singh, V, Nath, UK, Kumar, S, Rai, V, Kaushal, K, et al.. Immune dysfunction and multiple treatment modalities for the SARS-CoV-2\u00a0pandemic: races of uncontrolled running sweat? Biology 2020;9:243. https:\/\/doi.org\/10.3390\/biology9090243.","DOI":"10.3390\/biology9090243"},{"key":"2026082814564535076_j_med-2026-1511_ref_026","doi-asserted-by":"crossref","unstructured":"Lepp\u00e4niemi, A, Tolonen, M, Tarasconi, A, Segovia-Lohse, H, Gamberini, E, Kirkpatrick, AW, et al.. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg 2019;14:27. https:\/\/doi.org\/10.1186\/s13017-019-0247-0.","DOI":"10.1186\/s13017-019-0247-0"},{"key":"2026082814564535076_j_med-2026-1511_ref_027","doi-asserted-by":"crossref","unstructured":"Yao, H, Zhang, A, Li, D, Wu, Y, Wang, CZ, Wan, JY, et al.. Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis. Bmj 2024;384:e076410. https:\/\/doi.org\/10.1136\/bmj-2023-076410.","DOI":"10.1136\/bmj-2023-076410"},{"key":"2026082814564535076_j_med-2026-1511_ref_028","doi-asserted-by":"crossref","unstructured":"Zhang, X, Wang, Y, Cai, Z, Wan, Z, Aihemaiti, Y, Tu, H. A gonadal gap junction INX-14\/Notch GLP-1 signaling axis suppresses gut defense through an intestinal lysosome pathway. 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