scholarly journals Changes in Inflammatory Biomarkers Related to C-reactive Protein and Albumin in Patients With Terminal Cancer Receiving Palliative Care: a Longitudinal Study

2021 ◽  
Author(s):  
EMANUELLY VAREA MARIA WIEGERT ◽  
LARISSA CALIXTO-LIMA ◽  
GABRIELLA DA COSTA CUNHA ◽  
Tais Saint Martin Fonseca ◽  
GEISIANE ALVES DA SILVA ◽  
...  
Keyword(s):  
Palliative Care ◽  
Inflammatory Biomarkers ◽  
Longitudinal Change ◽  
Terminal Cancer ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Time Period ◽  
Cancer Trajectory ◽  
End Stage

Abstract Background: Evidence about how inflammatory biomarkers vary during the end-stage cancer trajectory is lacking. This study investigates the longitudinal changes in albumin and C-reactive protein (CRP) levels, and CRP/albumin ratio (CAR) in patients with terminal cancer receiving palliative care in the last three months of life.Methods: This is a retrospective analysis of variables extracted from a prospective cohort study that included admitted patients to the exclusive Palliative Care Unit of the National Cancer Institute in Brazil. Routine blood examination results of albumin and CRP were recorded at 0-15 (T1), 16-30 (T2), 31-45 (T3), 46-60 (T4), 61-75 (T5), and 76-90 (T6) days before death and only patients with at least two measurements were included. Crude and adjusted linear mixed-effects regression models were performed to verify the relationships between the longitudinal trajectories of biomarkers and death. Results: A total of 1,635 patients were included. Median albumin was 3.00g/dL across the whole time-period analyzed (interquartile range, IQR: 2.50-3.60) and decreased with the approach of death, while median CRP was 9.31mg/L (IQR: 4.42-17.30) and CAR was 3.20 (IQR: 1.40-6.60), and both increased. The albumin (slope: 0.01 to 0.02; p <0.001), CRP (slope: -0.10 to -0.12; p <0.001), and CAR (slope: -0.06; p <0.001) showed a linear dose-response relationship with death in crude and adjusted models tested. Conclusions: The longitudinal change levels of inflammatory biomarkers worsen with the approach of death and could be used to predict end-stage in patients with terminal cancer.

scholarly journals Prediction of Treatment Outcome with Inflammatory Biomarkers after 2 Months of Therapy in Pulmonary Tuberculosis Patients: Preliminary Results

Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 789
Author(s):  
Simona Stefanescu ◽  
Relu Cocoș ◽  
Adina Turcu-Stiolica ◽  
Elena-Silvia Shelby ◽  
Marius Matei ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Characteristic Curve ◽  
White Blood Cells ◽  
Inflammatory Biomarkers ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Tuberculosis Patients ◽  
Preliminary Results ◽  
Reactive Protein ◽  
Antituberculosis Treatment

Pro-inflammatory mediators play an important role in the pathogenesis of pulmonary tuberculosis. Consecutively, 26 pulmonary tuberculosis patients were enrolled in our study based on the exclusion criteria. We have used Spearman’s correlation analysis, hierarchical clustering and regression modelling to evaluate the association of 11 biomarkers with culture status after antituberculosis treatment. The results of our study demonstrated that six inflammatory biomarkers of 11, C-reactive protein (CRP), white blood cells (WBC), neutrophils, interferon gamma inducible protein 10, C-reactive protein (CRP) to albumin ratio (CAR) and neutrophil to albumin ratio (NAR), were significantly associated with culture negativity. The predictive ability of a composite model of seven biomarkers was superior to that of any single biomarker based on area under the receiver operating characteristic curve (AUC) analysis, indicating an excellent prediction efficacy (AUC:0.892; 95% CI:0.732-1.0). We also found that the highest significant trends and lower levels of CRP and IP-10 were observed in the two-month treated tuberculosis (TB) patients. We believe that our study may be valuable in providing preliminary results for an additional strategy in monitoring and management of the clinical outcome of pulmonary tuberculosis. Using a panel of predictors added a superior value in predicting culture status after anti-TB therapy.

Value of C-Reactive Protein/Albumin Ratio in Predicting the Development of Contrast-Induced Nephropathy in Patients With Non-ST Elevation Myocardial Infarction

Angiology ◽  
2020 ◽  
Vol 71 (4) ◽  
pp. 366-371 ◽  
Author(s):  
Seckin Satilmis ◽  
Ahmet Karabulut
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Inflammatory Biomarkers ◽  
Left Ventricular Ejection ◽  
C Reactive Protein ◽  
Contrast Induced Nephropathy ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
St Elevation

Contrast-induced nephropathy (CIN) accounts for about 10% of all hospital-acquired acute kidney injury. We aimed to assess the role of the combination of 2 inflammatory biomarkers, the C-reactive protein (CRP)/albumin ratio (CAR), in the development of CIN after percutaneous coronary intervention (PCI) in patients with non-ST-elevation myocardial infarction (NSTEMI). Patients with NSTEMI (n = 205) treated by PCI were classified according to the development of CIN. Both groups were compared according to clinical, laboratory, and demographic characteristics, including inflammatory biomarkers and specifically, CAR. Contrast-induced nephropathy was observed in 10.2% of patients. More advanced age, the presence of diabetes and dyslipidemia, left ventricular ejection fraction, and CAR correlated with the development of CIN. Analysis also showed a significant association between CAR and the development of CIN (CAR in CIN (+): 8.54 ± 8.48, range: 0.7-32, median: 7.13 vs CAR in CIN (−): 2.36 ± 3.01, range: 0.1-24, median: 1.33, P < .001). Multivariate logistic regression analysis showed the impact of CAR on the development of CIN (odds ratio: 1.244, 95% confidence interval: 1.102; 1.392, P < .01). We conclude that CAR, as a combination of 2 inflammatory biomarkers, is a more accurate predictor of CIN development compared with the single-marker assessment of albumin and CRP in the context of NSTEMI.

P1582Prognostic value of C-reactive protein/albumin ratio for cardiovascular morbidity and mortality in end-stage renal disease patients with incident haemodialysis therapy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Takahashi ◽  
H Ishii ◽  
Y Kumada ◽  
T Oshima ◽  
T Sakakibara ◽  
...  
Keyword(s):  
Risk Factors ◽  
End Stage Renal Disease ◽  
Survival Rates ◽  
Morbidity And Mortality ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background Hypoalbuminemia, a manifestation of protein-energy wasting or malnutrition, is commonly observed in patients with end-stage renal disease (ESRD), and is associated with chronic inflammation and increasing cardiovascular (CV) risk. Recently, C-reactive protein (CRP)/albumin ratio at discharge is reportedly a well-predictor of mortality in severe sepsis or cancer patients. We investigated prognostic value of the CRP/albumin ratio at just starting haemodialysis (HD) therapy for CV morbidity and mortality in patients with ESRD. Methods A total of 1,548 ESRD patients were enrolled and were divided into quartiles according to CRP/albumin levels at initiation of HD; quartile 1 (Q1): <0.22, Q2: 0.23–0.54, Q3: 0.55–1.83 and Q4: >1.84. They were followed up for 10-year after starting HD therapy. Primary endpoint was CV events defined as hospitalization due to CV events such as cardiac disease, stroke and peripheral artery disease and CV death. We also evaluated the incremental value with C-index when CRP alone, albumin alone and the CRP/albumin ratio were added into a model with established risk factors. Results During follow-up period (median: 59 months), 512 cases experienced CV events (33.1%) including 165 cases of CV deaths (10.7%). Kaplan-Meier analysis shows that CV event-free survival rates for 10 years were 63.5%, 53.8%, 47.5% and 31.9% in Q1, Q2, Q3 and Q4, and that CV survival rates were 90.4%, 83.9%, 77.2% and 64.6% in Q1, Q2, Q3 and Q4, respectively (p<0.0001 in both). After adjustment for all baseline variables, elevated CRP/albumin ratio was identified as an independent predictor for CV events [hazard ratio (HR) 1.51, 95% confidence interval (CI) 1.11–2.07, p=0.0093 for Q2 vs. Q1, HR 1.79, 95% CI 1.33–2.42, p<0.0001 for Q3 vs. Q1and HR 2.27, 95% CI 1.70–3.07, p<0.0001 for Q4 vs. Q1, respectively]. As to CV mortality, similar results were obtained (HR 1.80, 95% CI 0.98–3.44, p=0.056 for Q2 vs. Q1, HR 2.56, 95% CI 1.45–4.71, p=0.0009 for Q3 vs. Q1 and HR 2.66, 95% CI 1.53–4.86, p=0.0004 for Q4 vs. Q1, respectively). Furthermore, adding the CRP/albumin ratio to a baseline model with established risk factors improved the C-index greater than that of CRP alone or albumin alone, respectively (0.715 from 0.692, p=0.0095 and from 0.683, p=0.0019) Conclusion The CRP/albumin ratio, which easily available from daily practice, could strongly stratify the risk of future CV morbidity and mortality in ESRD patients who need HD therapy.

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

2019 ◽  
Vol 39 (11) ◽  
pp. 6283-6290 ◽  
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

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

BMC Surgery ◽  
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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