Abstract
Abstract Objectives This study aimed to evaluate the relationship between C-reactive protein/albumin (CRP/Alb), neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR) ratios and the Acute Physiology And Chronic Health Evaluation II (APACHE II) score and 28-day mortality among 400 patients admitted to internal medicine and anesthesia reanimation intensive care unit (ICU). Methods This prospective study included a total of 400 patients who were admitted to hospital internal medicine and anesthesia reanimation ICUs. Results The most common reasons for ICU admission were pneumonia (29.3%), gastrointestinal bleeding (10.3%), acute exacerbation of chronic kidney disease (CKD) (10.3%), and acute kidney injury (7.5%). The comparison of the laboratory findings with survival outcomes revealed that among the patients with acute exacerbation of CKD, the median NLR (p=0.043) and median CRP/Alb (p=0.021) were significantly higher in patients who died. For all of the patients, the APACHE II score was positively correlated with CRP (p<0.001) and CRP/Alb (p<0.001), negatively correlated with Alb (p<0.001), positively correlated with the NLR (p<0.001), and positively correlated with the PLR. Conclusions The APACHE II score was significantly correlated with the CRP/Alb ratio, NLR, and PLR. The NLR and CRP/Alb ratio were statistically associated with mortality in patients hospitalized for acute exacerbation of CKD.
Highlights
Intensive care scoring systems are widely used to predict recovery, determine the severity of the disease and the degree of organ dysfunction, evaluate treatment effectiveness, standardize patients in clinical trials, and compare the performances of intensive care units (ICUs)
The neutrophil/lymphocyte ratio (NLR) and C-reactive protein/albumin (CRP/Alb) ratio were statistically associated with mortality in patients hospitalized for acute exacerbation of chronic kidney disease (CKD)
This study aimed to evaluate the relationship between the C-reactive protein (CRP)/Alb ratio, NLR, and platelet/lymphocyte ratio (PLR), and the Acute Physiology and Chronic Health Examination (APACHE) II score and 28-day mortality among 400 patients admitted to the ICU for various reasons
Summary
Intensive care scoring systems are widely used to predict recovery, determine the severity of the disease and the degree of organ dysfunction, evaluate treatment effectiveness, standardize patients in clinical trials, and compare the performances of intensive care units (ICUs). The Acute Physiology and Chronic Health Examination (APACHE) II score was originally developed for critically ill patients in intensive care units (ICUs). It consists of three parts: acute physiology score, age and chronic health assessment. Usta et al.: APACHE II and mortality with CRP/Alb, NLR and PLR ratios (Table 1). The results from these three sections are summed and patient mortality is determined. Chronological age was added as a weighted score, since it reflects the decrease in physiological reserve and is an important factor that determines the risk of mortality regardless of disease severity in case of acute illness. Alternative scoring systems are needed for patient assessment in the ICU
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