A NEW large-scale study has found that the lactate-to-glucose ratio (LGR) could serve as a valuable predictor of short-term mortality among critically ill patients with cirrhosis. The findings suggest that this simple metabolic marker may help clinicians identify patients at highest risk of death during intensive care.
A search for better risk indicators
Patients with advanced liver cirrhosis face exceptionally high mortality rates, yet reliable prognostic indicators remain limited. To address this gap, researchers led by Dr Xingyi Yang and colleagues analysed data from two major critical care databases: the Medical Information Mart for Intensive Care IV (MIMIC-IV) and the eICU Collaborative Research Database (eICU-CRD).
The combined cohort included 3,366 patients from MIMIC and 478 from eICU-CRD, with ICU mortality rates of 27.8% and 22.0%, respectively.
Elevated LGR signals poorer survival
Using advanced statistical tools, including Boruta feature selection, multivariable Cox regression, and Kaplan–Meier survival analysis—the researchers found that a higher LGR was strongly linked to greater risk of 30-day mortality.
An optimal cutoff value of 0.68 was identified, with patients above this threshold classified as high-risk. Those with elevated LGRs showed significantly lower survival probabilities (P < 0.001), even after adjusting for confounding clinical factors.
Receiver operating characteristic (ROC) analysis confirmed the LGR’s moderate predictive accuracy, while restricted cubic spline regression demonstrated a positive, near-linear relationship between LGR and mortality risk.
Towards rapid, bedside risk assessment
The authors concluded that the lactate-to-glucose ratio represents a practical and accessible biomarker that could enhance early risk stratification for patients with severe cirrhosis.
Further prospective validation could pave the way for integrating LGR into routine ICU assessment protocols.
Reference
Yang X et al. Lactate-to-glucose ratio and short-term all-cause mortality in critically ill cirrhosis patients: a MIMIC-IV and eICU-CRD database study. BMC Gastroenterol. 2025;DOI: 10.1186/s12876-025-04359-z.
