Abstract
This study aimed to examine the prognostic value of C-reactive protein (CRP)/albumin (ALB) ratio among patients who were admitted to the intensive care unit (ICU) in predicting 30-day mortality rate. This retrospective cohort study was conducted by examining the medical records of adult patients who were admitted to the ICU at Seoul National University Bundang Hospital between 1 January 2012 and 31 December 2016. Data from 6,972 individuals were included in the final analysis, and 547 of these individuals (7.1%) died within 30 days after their ICU admission. The multivariable Cox regression analysis revealed that an increase of 1 for the CRP/ALB ratio was associated with an 11% increase in the risk of 30-day mortality (hazard ratio: 1.11, 95% confidence interval: 1.09–1.14, P < 0.001). However, the area under curve of CRP/ALB ratio in receiver operating characteristic analysis was lower than that of Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II, Charlson comorbidity index, or serum albumin alone. Although an elevated CRP/ALB ratio on ICU admission was an independent risk factor for 30-day mortality rate, the predictive power of CRP/ALB ratio was lower than that of albumin alone, APACHE II, and Charlson comorbidity index.
Highlights
C-reactive protein (CRP) and serum albumin (ALB) are useful markers that can predict morbidity and mortality among critically ill patients[1,2]
The multivariable Cox proportional hazard model revealed that an increase of 1 for the CRP to ALB (CRP/ALB) ratio was associated with an Variables Sex: male Age, year Body mass index, kg m−2 Postoperative intensive care unit (ICU) admission Department of ICU admission: IM (Ref: Non-IM) APACHE II Charlson Comorbidy Index Comorbidity at ICU admission Hypertension Diabetes mellitus Ischemic heart disease COPD Cancer C-Reactive Protein Albumin (g/L) C-Reactive Protein/Albumin ratio
The present study revealed that an elevated CRP/ALB ratio at the ICU admission was independently associated with an increased risk of 30-day mortality
Summary
C-reactive protein (CRP) and serum albumin (ALB) are useful markers that can predict morbidity and mortality among critically ill patients[1,2]. As the CRP/ALB ratio effectively reflects both inflammation and malnutrition[11,12], it may be a useful biochemical marker for predicting prognosis among critically ill patients. The study did not assess the value of the CRP/ALB ratio compared with that of other prognostic factors such as APACHE II or Charlson comorbidity index. The present study aimed to examine the relationship between the CRP/ALB ratio and risk of 30-day mortality among all patients who were admitted to our centre’s ICU. Compare the CRP/ALB ratio with other prognostic factors (APACHE II, Charlson comorbidity index) in predicting 30-day mortality after ICU admission
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