This retrospective study included 631 patients with acute pulmonary embolism; 41 (6.5%) died in hospital. Admission glucose-to-lymphocyte ratio (GLR) had modest mortality discrimination (area under the curve 0.626, 95% confidence interval 0.548–0.705). An exploratory GLR threshold of 80.06 was associated with mortality in the primary multivariable model (adjusted odds ratio 2.43, 95% confidence interval 1.15–5.15). After additional adjustment for active infection, the association weakened and was no longer statistically significant (adjusted odds ratio 1.85, 95% confidence interval 0.86–3.97), limiting confidence in its independent prognostic value.
GLR showed modest prognostic discrimination in acute pulmonary embolism, but its mortality association was sensitive to adjustment for active infection. These findings do not establish a clinically actionable threshold.
Study limitation: Retrospective observational design and a data-derived exploratory threshold limit causal interpretation and confidence in generalizability.
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