Abstract
BACKGROUND: The leukocyte-to-albumin ratio (LAR) serves as an integrated marker of both inflammation and nutritional status. However, there is currently a lack of research on the correlation between LAR and the prognosis of valvular heart disease (VHD) surgery patients. This study investigates the prognostic significance of LAR in patients undergoing VHD surgery. METHODS: This is a single-center, retrospective cohort study. From May 2021 to July 2024, we retrospectively analyzed the clinical data of 773 patients who underwent VHD surgery. Patients were categorized into low- and high-LAR groups using a threshold value of 0.2. Multivariable logistic regression models were used to assess the association between the LAR and adverse outcomes. RESULTS: This study included a total of 773 patients, with 615 in the low LAR group and 158 in the high LAR group. The main findings included that LAR ≥ 0.2 was an independent protective factor for severe arrhythmias(SA)(OR:0.231, 95% CI:0.103-0.518, p=0.000), but was also significantly associated with increased risk of acute kidney injury(AKI), prolonged mechanical ventilation(MV) time and prolonged length of stays(LOS)(p < 0.05). Multifactorial analysis further confirmed that LAR was independently and positively associated with LOS (B=16.453, t=3.090, p=0.002). CONCLUSION: In summary, an elevated LAR (≥0.2) exhibits a paradoxical role, serving as an independent predictor for reduced SA while concurrently correlating with an extended LOS, thereby establishing its dual nature as a perioperative risk biomarker.