The lactate dehydrogenase-to-albumin ratio (LAR) reflects the balance between tissue injury and metabolic reserve, yet its prognostic value in steroid-treated pneumonia remains undefined.<h4>Methods</h4>This multicenter study utilized a primary cohort (n=500) and an independent external validation cohort (n=354) of pneumonia patients receiving glucocorticoid therapy. Here, ALB is linked to susceptibility to pneumonia measurement.