scholarly journals The C-Reactive Protein/Albumin Ratio as a Predictor of Mortality in Critically Ill Patients

2018 ◽  
Vol 7 (10) ◽  
pp. 333 ◽  
Author(s):  
Ji Park ◽  
Kyung Chung ◽  
Joo Song ◽  
Song Kim ◽  
Eun Kim ◽  
...  

The C-reactive protein (CRP)/albumin ratio has recently emerged as a marker for poor prognosis or mortality across various patient groups. This study aimed to identify the association between CRP/albumin ratio and 28-day mortality and predict the accuracy of CRP/albumin ratio for 28-day mortality in medical intensive care unit (ICU) patients. This was a retrospective cohort study of 875 patients. We evaluated the prognostic value of CRP/albumin ratio to predict mortality at 28 days after ICU admission, using Cox proportional hazard model and Kaplan-Meier survival analysis. The 28-day mortality was 28.0%. In the univariate analysis, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score (p < 0.001), CRP level (p = 0.045), albumin level (p < 0.001), and CRP/albumin ratio (p = 0.032) were related to 28-day mortality. The area under the receiver operating characteristic (ROC) curve (the area under the ROC curves (AUC)) of CRP/albumin ratio was higher than that of CRP for mortality (0.594 vs. 0.567, p < 0.001). The cut-off point for CRP/albumin ratio for mortality was 34.3. On Cox proportional-hazard regression analysis, APACHE II score (hazards ratio (HR) = 1.05, 95% confidence interval (CI) = 1.04–1.07, p < 0.001) and CRP/albumin ratio (HR = 1.68, 95% CI = 1.27–2.21, p < 0.001 for high CRP/albumin ratio) were independent predictors of 28-day mortality. Higher CRP/albumin ratio was associated with increased mortality in critically ill patients.

Medicine ◽  
2019 ◽  
Vol 98 (26) ◽  
pp. e16204 ◽  
Author(s):  
Anibal Basile-Filho ◽  
Alessandra Fabiane Lago ◽  
Mayra Gonçalves Menegueti ◽  
Edson Antonio Nicolini ◽  
Lorena Aparecida de Brito Rodrigues ◽  
...  

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Walid H Nofal ◽  
Sahar K Abo Alela ◽  
Moustafa M Aldeeb ◽  
Gamal M Elewa

Abstract Background Despite all worldwide efforts towards sepsis, more than 5.3 million patients die annually. Till now, there is no parameter or score to detect mortality in septic patients precisely. Objectives The aim of this study was to evaluate the prognostic performance of the lactate/albumin (L/A) ratio when combined with APACHE II score, SOFA score and SAPS II for predicting 28-day mortality in critically ill patients with septic shock. Patients and Methods After approval of the Medical Ethics Committee of Ain Shams Faculty of Medicine, an informed consent was taken from the patient or next of kin to include his/her data in this study. All patients who were admitted to the intensive care units (ICUs) with septic shock from 1st of September, 2019 to 30th of March, 2020 were assessed for enrollment in this study. Results In this prospective observational study, 100 adult patients of both sexes with septic shock were enrolled. They were categorized into two groups according to the primary endpoint (outcome) “28-days mortality”. Sixty-one patients (61%) died (non-survivors’ group) and thirtynine patients (39%) survived (survivors group). The most significant factors which affecting the mortality were LAR, SOFA score on admission, APACHE II, and SAPS II score. Prediction performance of the four variables for estimating 28 days mortality. When combined LAR + SOFA, LAR + APACHE, LAR + SAPS II, Overall score the ROC (AUROC, 0.867,0.847,0.849,,0.899 respectively) was the highest, compared to the other single models and lower cutoff (&gt;0.48, &gt;0.53, &gt;0.42, &gt;0.47 respectively)in comparison to single scores. Moreover, the overall score (including the 4 parameters together) gave the best predictive value for 28 day mortality Conclusion Lactate/Albumin ratio combined with APACHI II, SOFA and SAPS scores gave the best predictive value for 28 day mortality in septic shock patients, when compared with each separate score Recommendations combined LAR + SOFA, LAR + APACHE, LAR + SAPS II, Overall score recommended to use to predictho spital mortality, Further research on large sample sizeto study the risk stratification and implementing new scores using the lactate/albumin ratio (LAR) is needed. Simple, available and cheap markers should be used in developing new prediction scores.


2020 ◽  
Author(s):  
Ismail Necati Hakyemez ◽  
Turan Aslan ◽  
Bulent Durdu

Abstract Background: This study was performed to investigate the combination of serum C-reactive protein (CRP) and procalcitonin (PCT) kinetics as a best marker in predicting mortality in patients with nosocomial blood stream infection (BSI).Methods: We retrospectively reviewed the medical records of patients ≥ 18 years of age with nosocomial BSIs hospitalized in intensive care units during the period from January 2016 to June 2018. Eighty-four patients who met the inclusion criteria were included in the study. Clinical, microbiological and biochemical data were compared in patients who survivors and deaths. Binary logistic regression analyses (backward LR) were used to identify independent risk factors. A receiver operating characteristic (ROC) curve analysis was performed to compare the predictive accuracy. The kinetic changes were expressed as Δ (delta) and defined the as difference between level on day 5 and level at day 1 of BSI.Results: Of the 84 included patients, 46 (58.4%) had survivors and 35 (41.6%) had deaths. In univariate analysis, renal disease (p = 0.007), cardiac disease (p = 0.042), septic shock (p = <0.001), maximum SOFA (p = <0.001) and APACHE-II (p <0.001), ΔCRP (p = 0.004), ΔPCT (p = <0.001), and ΔPCR (p = 0.025) were significantly higher in non-survivors than in survivors. In the logistic regression analysis, APACHE-II score (odds ratio (OR) = 1.46, 95% confidence interval (CI) = 1.20-1.78, p <0.001), ΔCRP (OR = 1.18, %95 CI =1.04-1.34, p = 0.009), ΔPCT (OR = 0.87, 95% CI = 0.79-0.95, p = 0.001), and ∆PCR (OR = 36.78, 95% CI = 4.52-299.01, p = 0.001) were independent predictors of 28-day mortality. After a ROC analysis, the AUC of ∆PCR was higher than that of ∆PCT for mortality in ICU patients (0.745 vs. 0.712, p <0.001).Conclusions: The PCR kinetic was a strong independent predictor of mortality in patients with nosocomial BSIs in intensive care units. Especially in patients with CRP and PCT tested together, it is expected to be a fast and rational tool for clinical practice.


2020 ◽  
Author(s):  
Ismail Necati Hakyemez ◽  
Turan Aslan ◽  
Bulent Durdu

Abstract Purpose: To investigate the combination of serum C-reactive protein (CRP) and procalcitonin (PCT) kinetics in predicting mortality in nosocomial blood stream infections (BSIs).Materials and Methods: We retrospectively reviewed the medical records of patients ≥ 18 years of age with nosocomial BSIs hospitalized in intensive care units (ICU). Clinical, microbiological and biochemical data were compared in patients who survivors and deaths. Binary logistic regression analyses were used to identify independent risk factors. The kinetic changes were defined the as difference between level on 5th day and level at 1st day of BSI.Results: Of the 84 included patients, 49 (58.4%) had survivors and 35 (41.6%) had deaths. In univariate analysis, renal disease (p=0.007), cardiac disease (p=0.042), septic shock (p=<0.001), SOFA (p=<0.001) and APACHE-II (p <0.001), ΔCRP (p=0.004), ΔPCT (p=<0.001), and ΔPCR (p=0.025) were significantly higher in non-survivors. In the logistic regression analysis, APACHE-II score (OR=1.46, 95% CI=1.20-1.78, p <0.001), ΔCRP (OR=1.18, %95 CI =1.04-1.34, p=0.009), ΔPCT (OR=0.87, 95% CI=0.79-0.95, p=0.001), and ∆PCR (OR=36.78, 95%C = 4.52-299.01, p=0.001) were independent predictors of 28-day mortality.Conclusions: The ∆PCR kinetic was a strong independent predictor of mortality in nosocomial BSIs in ICUs.


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