An observational study in Acute Respiratory Failure, Critical Illness and Mortality, sponsored by Kocaeli City Hospital. Not yet recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-02.
Sponsored by Kocaeli City Hospital · Observational
This retrospective observational study aims to evaluate the association between the lactate-to-albumin ratio (LAR) measured at ICU admission and 28-day mortality in adult patients admitted to the intensive care unit with acute respiratory failure. The study will also compare the prognostic value of LAR with that of existing clinical and laboratory parameters.
Acute respiratory failure is a common cause of intensive care unit (ICU) admission and is associated with high short-term mortality. Early risk stratification is important for guiding treatment intensity and resource allocation. Serum lactate reflects tissue hypoperfusion and impaired oxygen utilization, whereas serum albumin is a marker of nutritional status, systemic inflammation, and capillary leak. The lactate-to-albumin ratio (LAR) combines these two readily available laboratory parameters and has been proposed as a prognostic marker in critically ill patients. However, its prognostic value in patients with acute respiratory failure has not been well established.
This is a single-center, retrospective observational cohort study conducted at [center name], including adult patients (≥18 years) admitted to the ICU with acute respiratory failure between April 2023 and June-2026. Data will be obtained from the hospital information system and ICU records.
The primary objective is to evaluate the association between LAR at ICU admission and 28-day all-cause mortality. The secondary objective is to compare the prognostic performance of LAR with that of serum lactate alone, serum albumin alone, and established severity scores (e.g., APACHE II, SOFA).
The following data will be collected: demographic characteristics, comorbidities, cause of respiratory failure, need for invasive mechanical ventilation, severity scores, laboratory parameters (including lactate and albumin measured at ICU admission), ICU and hospital length of stay, and 28-day survival status. LAR will be calculated as serum lactate (mmol/L) divided by serum albumin (g/dL) .
Patients will be grouped as survivors and non-survivors at 28 days. The association between LAR and mortality will be assessed using logistic regression and/or Cox proportional hazards models adjusted for relevant confounders. Discriminative ability will be evaluated with receiver operating characteristic (ROC) curve analysis, and the optimal cut-off value will be determined. AUC values of LAR and the comparator parameters will be compared
1,931 studies on the registry are indexed under Critical Illness; 469 are open to participants now.
This study's planned enrollment of 1,250 is above the median of 130 across 887 observational studies indexed under Critical Illness.
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Adult patients (≥18 years) admitted for the first time to the intensive care unit of the Department of Anesthesiology and Reanimation, Kocaeli City Hospital, Turkey, with a diagnosis of acute respiratory failure between April 2023 and June 2026. Data will be retrospectively obtained from the hospital information system and patient records.
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Exclusion Criteria:
Adult (≥18 years) patients admitted to the ICU with acute respiratory failure between April 2023 and June 2026, in whom lactate and albumin were measured at ICU admission. LAR will be calculated and its association with 28-day mortality will be evaluated.
Diagnostic Test: Assessment of Admission Serum Lactate-to-Albumin Ratio (LAR)
In this observational cohort study, no experimental clinical intervention was administered. The primary exposure variable (prognostik marker/predictor) evaluated is the Lactate-to-Albumin Ratio (LAR), calculated from serum lactate level (mmol/L) divided by serum albumin level (g/dL) measured within the first 24 hours of intensive care unit admission.
Prognostic performance of LAR for 28-day mortality
Discriminative ability of LAR at ICU admission for predicting 28-day mortality, assessed by the area under the receiver operating characteristic curve (AUC), with determination of the optimal cut-off value.
Time frame: 28 days after ICU admission
7-day mortality
Death from any cause within 7 days after ICU admission.
Time frame: 7 days after ICU admission
Comparison of LAR with serum lactate and serum albumin alone
Comparison of the predictive performance (AUC) of LAR with that of lactate alone and albumin alone for 28-day mortality.
Time frame: 28 days after ICU admission
Plan to share: No — The study data may be shared upon an appropriate request and institutional approval. It is not publicly available.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is not yet recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
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Kocaeli City Hospital