C-reactive protein/albumin ratio as a predictor of 28 day mortality in patients with sepsis

Background: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis remains a major cause of morbidity and mortality worldwide. Important biomarkers that can be used as prognostic markers in sepsis are C Reactive Protein (CRP) and serum Albumin levels. CRP levels markedly elevate in response to infection whereas albumin levels decrease in response to acute phase infection. We want to ascertain the value of CRP/albumin ratio as an independent predictor of 28-day mortality in sepsis patients.Methods: A prospective study was conducted including 150 patients satisfying the criteria for sepsis according to SOFA score of more than 2. Initial CRP/Albumin ratio was assessed to determine its significance in assessing the 28-day mortality, primary end point of our study. Secondary end points assessed were length of ICU stay, need for inotropic support, need for ventilator support and renal replacement therapy.Results: In the analysis of CRP/Albumin ratio as a predictor of 28-day mortality, patients were followed up from day of admission till 28 days to assess primary outcome. Among study subjects survivors were 92 in whom mean CRP/ALB ratio was 0.1197 and non survivors were 58 patients with mean CRP/ALB ratio was 0.0426. p-value <0.001, there was statistically significant difference found between survivor and Non-Survivor with respect to CRP/Albumin ratio. In assessing secondary outcome statistically significant association was found for need for ventilator and inotropic support, whereas it was insignificant in assessing need for dialysis and length of ICU stay.Conclusions: CRP/albumin ratio, which indicates the extent of residual inflammation, could be used as a prognostic marker in predicting mortality in patients with sepsis and septic shock.

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Development of Pharyngocutaneous Fistula after Total Laryngectomy: The Predictive Value of C-reactive Protein/Albumin Ratio

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2020.58 ◽

2020 ◽

Vol 63 (4) ◽

pp. 159-163

Author(s):

Abitter Yücel ◽

Hilal Yücel ◽

Fuat Aydemir ◽

Mert Mutaf ◽

Mehmet Akif Eryılmaz ◽

...

Keyword(s):

Postoperative Period ◽

Total Laryngectomy ◽

Linear Regression Analysis ◽

Multiple Linear Regression Analysis ◽

Early Postoperative Period ◽

Pharyngocutaneous Fistula ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein ◽

Significant Difference

Background: We aimed to evaluate whether C-reactive protein(CRP)/ Albumin ratio (CAR) performed in the early postoperative period after total laryngectomy could be a predictive factor for the development of pharyngocutaneous fistula (PCF). Methods: The files of patients with laryngeal squamous cell carcinoma who underwent total laryngectomy between January 2005 and January 2019 were retrospectively reviewed. Patients were divided into two groups: patients with PCF (PCF group) and without (Non-PCF group). CAR values and risk factors were compared between groups. Results: The overall incidence of PCF was 23.2%. There was a statistically significant difference between the two groups in terms of CRP and CAR levels (p = 0.001). The CAR value of 27.05 (sensitivity = 75.0% , specificity 68.2%, area under curve (AUC) = 0.742, 95% confidence interval 0.616–0.868) was determined as a cutoff value to describe the development of fistula in the early postoperative period. In multiple linear regression analysis, there was an independent relationship between presence of PCF and previous RT and CAR value. Conclusions: CAR, performed in the early postoperative period, may be a new and useful marker for predicting PCF after total laryngectomy.

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C-reactive protein/albumin ratio as a prognostic biomarker in critically ill septic patients: a prospective study

10.1183/13993003.congress-2020.2751 ◽

2020 ◽

Author(s):

Irene Karampela ◽

Evangelia Chrysanthopoulou ◽

Panagiotis Simitsis ◽

George Skyllas ◽

Gerasimos Socrates Christodoulatos ◽

...

Keyword(s):

Prospective Study ◽

Critically Ill ◽

Prognostic Biomarker ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein ◽

A Prospective Study

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C-Reactive Protein-to-Albumin Ratio as a Prognostic Inflammatory Marker in COVID-19

Journal of Laboratory Physicians ◽

10.1055/s-0041-1741439 ◽

2022 ◽

Author(s):

Aliye Çelikkol ◽

Eda Çelik Güzel ◽

Mustafa Doğan ◽

Berna Erdal ◽

Ahsen Yilmaz

Keyword(s):

Disease Severity ◽

Predictive Value ◽

Rt Pcr ◽

C Reactive Protein ◽

Albumin Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Cell Counts ◽

Nonparametric Distribution ◽

Significant Difference

Abstract Objectives As a result of developed generalized inflammation, the main prognostic factor determining morbidity and mortality in coronavirus disease 2019 (COVID-19) patients is acute respiratory distress syndrome. The purpose of our study was to define (1) the laboratory tests that will contribute to the diagnosis and follow-up of COVID-19 patients, (2) the differences between the laboratory-confirmed (LC), unconfirmed (LUC), and control (C) groups, and (3) the variation between groups of acute-phase reactants and biomarkers that can be used as an indicator of disease severity and inflammation. Materials and Methods A total of 102 patients undergoing treatment with COVID-19 interim guidelines were evaluated. Reverse transcriptase-polymerase chain reaction (RT-PCR) test was positive in 56 (LC), classified as mild or severe, and negative in 46 (LUC) patients. In addition, 30 healthy subjects (C) with negative RT-PCR tests were also evaluated.All statistical analyses were performed with the SPSS 22.0 program and the p-values for significant findings were less than 0.05. Parametric/nonparametric distribution was determined by performing the Kolmogorov–Smirnov test for all groups. Student's t-test was used for variables with parametric distribution and the Mann–Whitney U-test for variables with the nonparametric distribution. A cut-off level for biomarkers was determined using the ROC (receiver operator characteristic) curve. Results In the LC group, platelet, platecrit, mean platelet volume, platelet diameter width, white blood cell, lymphocyte, eosinophil, neutrophil, immature granulocyte, immature lymphocyte, immature monocyte, large immune cell, and atypical lymphocyte counts among the complete blood count parameters of mature and immature cell counts showed a significant difference according to the C and LUC groups. C-reactive protein, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and C-reactive protein-to-albumin ratio (CAR) indices were significantly elevated in LC patients and were significantly higher in patients classified as severe compared to mild. When CAR optimal cutoff was determined as 0.475, area under the curve was 0.934, sensitivity was 90.91%, specificity was 86.21%, positive predictive value was 92.59%, and negative predictive value was 83.33%. The diagnostic accuracy for CAR was 89.29%. Conclusion The CAR index with the highest diagnostic value and the highest predictability could be the most useful biomarker in the diagnosis and evaluation of disease severity in COVID-19 patients.

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SSI Following Construction of Colorectal Anastomoses and C-Reactive Protein as Marker for Infectious Complications

Creative Surgery and Oncology ◽

10.24060/2076-3093-2019-9-3-171-176 ◽

2019 ◽

Vol 9 (3) ◽

pp. 171-176

Author(s):

E. A. Grushevzkaya ◽

N. M. Mekhtiev ◽

E. E. Grishina ◽

M. V. Timerbulatov

Keyword(s):

Threshold Value ◽

Infectious Complications ◽

Colon Resection ◽

C Reactive Protein ◽

Colorectal Anastomoses ◽

Reactive Protein ◽

Significant Difference ◽

The Times ◽

Mechanical Anastomosis ◽

A Prospective Study

Introduction. Surgical site infection (SSI) incidence amounts to as much as 30% in patients after colorectal surgeries. Infectious complications after colorectal surgeries are characterised by the prevalence of deep forms of SSI with an unclear clinical presentation and difficulties in a timely diagnosis. An important aspect here is finding the earliest marker of the developing infectious complications and establishing its threshold value.Materials and methods. This is a prospective study of outcomes of colon resection and construction of colon anastomoses in 135 patients. Patients were split in two groups depending on the method of anastomosis construction. The C-reactive protein level was recorded prior to surgery and on days 3, 5, and 7 postop.Results and discussion. SSI was diagnosed in 32 patients (23.7%). Comparing the SSI incidence in different groups the authors established a statistically significant difference in favour of mechanical anastomosis; 9 patients (15.2%) against 23 patients (30.3%), р=0,0164. Statistically significant differences in CRP levels have been established between patients with SSI and patients without SSI at all the times the samples were taken postop. At the level of CRP higher than 100.5 mg/l (0.95 confidence range lower limit) the incidence of SSI increases significantly.Conclusion. Mechanical anastomosis conclusively reduces the incidence of SSI in the postop period by 15.1%. The CRP level of higher than 100.5 mg/l from day 3 postop can be considered a reliable predictor for the development of SSI.

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C - reactive protein predictive marker value and its significance in management of pre dialysis chronic kidney disease patients when correlated with total serum proteins and serum albumin levels: experience in a teaching institution

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20170102 ◽

2017 ◽

Vol 4 (1) ◽

pp. 162 ◽

Cited By ~ 1

Author(s):

Balvinder Singh Arora ◽

Indu Biswal ◽

Poornima Sen ◽

Santhosh Rajan ◽

Amjad Ali ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Serum Albumin ◽

Serum Proteins ◽

Total Serum ◽

P Value ◽

C Reactive Protein ◽

Reactive Protein ◽

Significant Difference ◽

The Mean

Background: Chronic kidney disease (CKD) is imposing newer challenges, not only globally, but, also in India, especially managing the end stage renal disease (ESRD). Screening for CKD at an early stage, by, high sensitivity C reactive protein (hsCRP) with or without other clinical, biochemical or anthropometric parameters helps initiate specific therapy to reduce the progression of renal disease. Although, malnutrition, inflammation and cardio vascular diseases (CVD) have been shown as significant independent risk factors of mortality in CKD patients, but, whether there exists any relationship between hsCRP and serum proteins and serum albumin levels, one of the important indicators of PEM, has not been extensively studied in pre-dialysis CKD patients.Methods: The study included a total of 60 adult subjects. Of these, 30 were study cases who fulfilled the case definition of CKD and were compared with 30 patients who did not show any signs or symptoms of CKD. As per the objective - hsCRP values were estimated by ELISA test, quantified and statistically correlated with total serum proteins and albumin levels.Results: A significant difference was found in the mean value of hsCRP in cases and in controls (p value 0.001). No significant difference was observed in the mean level of total serum protein in cases and controls, but, the mean differences in the level of serum albumin between cases and controls was significant. The association of serum albumin and hsCRP was found to be significant (p value <0.001). If a level of serum albumin < 3.5 is taken as a marker of malnutrition, it is found that 66.66% of patients have hypo-albuminaemia.Conclusions: The present study comes to an important conclusion that hsCRP is a useful independent predictor of CKD and if correlated with serum albumin levels, it would help clinician manage the patient effectively by initiating an aggressive yet very appropriate therapy at the pre-dialysis stage with the likelihood of an ‘evidence based’ reduction in morbidity and mortality.

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Impact of Roux-en-Y gastric bypass on lipid and inflammatory profiles

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-69912015005007 ◽

2015 ◽

Vol 42 (5) ◽

pp. 305-310 ◽

Cited By ~ 5

Author(s):

Cleiton da Silva Oliveira ◽

Bruna Teles Soares Beserra ◽

Raphael Salles Granato Cunha ◽

Ana Gabriela Estevam Brito ◽

Rafaella Cristina Dimbarre de Miranda ◽

...

Keyword(s):

Gastric Bypass ◽

Total Cholesterol ◽

Acute Phase ◽

Acute Phase Proteins ◽

Plasma Concentrations ◽

C Reactive Protein ◽

Acid Glycoprotein ◽

Reactive Protein ◽

Significant Difference ◽

A Prospective Study

Objective: To evaluate the behavior of acute phase proteins and lipid profile in patients undergoing Roux-en-Y gastric bypass. Methods : We conducted a prospective study, consisting of three moments: M1 - preoperative (24 hours before surgery); M2 - 30 days after surgery; and M3 - 180 days after surgery. We carried measured height and BMI, as well as determined the concentrations of acute phase proteins (C-reactive protein (CRP), albumin and Alpha-1-acid glycoprotein) and total cholesterol, LDL-c, HDL-c and triacylglycerol. Results : participants comprised 25 individuals, with a mean age of 39.28 ± 8.07, 72% female. At all times of the study there was statistically significant difference as for weight loss and BMI. We found a significant decrease in CRP concentrations between the moments M1 and M3 (p = 0.041) and between M2 and M3 (p = 0.018). There was decrease in Alpha-1-GA concentrations between M1 and M2 (p = 0.023) and between M1 and M3 (p = 0.028). The albumin values increased, but did not differ between times. Total cholesterol and triacylglycerol decreased significantly ay all times. LDL-c concentrations decreased and differed between M1 and M2 (p = 0.001) and between M1 and M3 (p = 0.001). HDL-c values increased, however only differing between M1 and M2 (p = 0.050). Conclusion : Roux-en-Y gastric bypass promoted a decrease in plasma concentrations of CRP and Alpha-1-acid glycoprotein, improving lipid and inflammatory profiles.

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The value of the Modified Early Warning Score and biochemical parameters as predictors of patient outcome in acute medical admissions: a prospective study

Acute Medicine Journal ◽

10.52964/amja.0491 ◽

2011 ◽

Vol 10 (3) ◽

pp. 126-132

Author(s):

Yashasvi Sanja Perera ◽

◽

Priyanga Ranasinghe ◽

Adikari Mudiyanselage Madura Adikari ◽

Welivitage Don Thilina Sampath Welivita ◽

...

Keyword(s):

Biochemical Parameters ◽

White Cell Count ◽

Albumin Level ◽

Adverse Outcomes ◽

Early Warning Score ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein ◽

Acute Medical Unit ◽

A Prospective Study

Abstract We evaluated the effectiveness of MEWS and biochemical parameters in predicting outcomes for acute medical admissions. Data from consecutive admissions to the Acute Medical Unit (AMU) of National Hospital of Sri Lanka were collected. C-reactive protein (CRP), albumin, white cell count, platelet count and haemoglobin values were collected. Adverse endpoints were HDU/ICU admission, cardio-respiratory emergency/resuscitation and death. A MEWS score of >=5 together with increasing age, pulse rate, respiratory rate, AVPU score, CRP, CRP/Albumin ratio and reduced platelet and albumin level all increased the odds of reaching ‘adverse endpoints”. Adding a score for biochemical parameters increased the area under the ROC curve for reaching “adverse endpoints’. Biochemical parameters better predicted length of hospitalstay and adverse outcomes. A combined scoring system improved the sensitivity of prediction.

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Predictive Significance of C-reactive Protein-to-albumin Ratio for Postoperative Pancreatic Fistula After Pancreaticoduodenectomy

Anticancer Research ◽

10.21873/anticanres.13838 ◽

2019 ◽

Vol 39 (11) ◽

pp. 6283-6290 ◽

Cited By ~ 2

Author(s):

TERUHISA SAKAMOTO ◽

YAKUKI YAGYU ◽

EI UCHINAKA ◽

MASAKI MORIMOTO ◽

TAKEHIKO HANAKI ◽

...

Keyword(s):

Pancreatic Fistula ◽

Postoperative Pancreatic Fistula ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein

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Dynamic prediction for clinically relevant pancreatic fistula: a novel prediction model for laparoscopic pancreaticoduodenectomy

BMC Surgery ◽

10.1186/s12893-020-00968-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Runwen Liu ◽

Yunqiang Cai ◽

He Cai ◽

Yajia Lan ◽

Lingwei Meng ◽

...

Keyword(s):

Prediction Model ◽

Pancreatic Fistula ◽

Postoperative Pancreatic Fistula ◽

Laparoscopic Pancreaticoduodenectomy ◽

C Reactive Protein ◽

Dynamic Prediction ◽

Albumin Ratio ◽

Drainage Fluid ◽

Reactive Protein ◽

Baseline Factors

Abstract Background With the recent emerge of dynamic prediction model on the use of diabetes, cardiovascular diseases and renal failure, and its advantage of providing timely predicted results according to the fluctuation of the condition of the patients, we aim to develop a dynamic prediction model with its corresponding risk assessment chart for clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy by combining baseline factors and postoperative time-relevant drainage fluid amylase level and C-reactive protein-to-albumin ratio. Methods We collected data of 251 patients undergoing LPD at West China Hospital of Sichuan University from January 2016 to April 2019. We extracted preoperative and intraoperative baseline factors and time-window of postoperative drainage fluid amylase and C-reactive protein-to-albumin ratio relevant to clinically relevant pancreatic fistula by performing univariate and multivariate analyses, developing a time-relevant logistic model with the evaluation of its discrimination ability. We also established a risk assessment chart in each time-point. Results The proportion of the patients who developed clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy was 7.6% (19/251); preoperative albumin and creatine levels, as well as drainage fluid amylase and C-reactive protein-to-albumin ratio on postoperative days 2, 3, and 5, were the independent risk factors for clinically relevant postoperative pancreatic fistula. The cut-off points of the prediction value of each time-relevant logistic model were 14.0% (sensitivity: 81.9%, specificity: 86.5%), 8.3% (sensitivity: 85.7%, specificity: 79.1%), and 7.4% (sensitivity: 76.9%, specificity: 85.9%) on postoperative days 2, 3, and 5, respectively, the area under the receiver operating characteristic curve was 0.866 (95% CI 0.737–0.996), 0.896 (95% CI 0.814–0.978), and 0.888 (95% CI 0.806–0.971), respectively. Conclusions The dynamic prediction model for clinically relevant postoperative pancreatic fistula has a good to very good discriminative ability and predictive accuracy. Patients whose predictive values were above 14.0%, 8.3%, and 7.5% on postoperative days 2, 3, and 5 would be very likely to develop clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy.

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