Analysis of the value of lactate dehydrogenase to albumin ratio as a predictor of early mortality in patients with sigmoid volvulus undergoing emergency surgery

Abstract

Aim: Sigmoid volvulus represents an important cause of mechanical large-bowel obstruction and may rapidly progress to life-threatening complications, particularly in elderly or frail patients. This study evaluated whether the preoperative lactate dehydrogenase-to-albumin ratio (LAR) predicts early mortality after emergency surgery for sigmoid volvulus.Methods: The retrospective study included 62 patients who underwent emergency surgery for the treatment of sigmoid volvulus at two tertiary centers between January 2015 and June 2025. A time-dependent receiver operating characteristic (ROC) curve was used to identify the best preoperative LAR threshold; the selected cutoff was 8.84. Factors associated with early postoperative mortality were assessed using logistic regression models.Results: Among the 62 patients, the mean age was 61.7±15.1 years (range: 19-84), and 52 patients (83.8%) were men. Seven patients (11.29%) died in the early postoperative period. Urea and creatinine elevation, perforation, LAR ≥8.84, and operative time >120 min were significant in univariate analysis. In the multivariable model, LAR remained independently associated with early mortality (odds ratio, 19.024; 95% confidence interval, 1.6895-214.20; P=0.017).Conclusion: A higher preoperative LAR was independently linked to early postoperative death in patients who required emergency surgery for sigmoid volvulus.