Abstract
Objective: The impact of increased C-reactive protein (CRP)/albumin ratio on intra-hospital mortality has been investigated among patients admitted to general intensive care units (ICU). However, it was not investigated among patients with spontaneous intracerebral hemorrhage (ICH). This study aimed to investigate the impact of CRP/albumin ratio on intra-hospital mortality in patients with ICH. Patients and Methods: This retrospective study was conducted on 379 ICH patients admitted between 02/2008 and 12/2017. Blood samples were drawn upon admission and the patients’ demographic, medical, and radiological data were collected. The identification of the independent prognostic factors for intra-hospital mortality was calculated using binary logistic regression and COX regression analysis. Results: Multivariate regression analysis shows that higher CRP/albumin ratio (odds ratio (OR) = 1.66, 95% confidence interval (CI) = 1.193–2.317, p = 0.003) upon admission is an independent predictor of intra-hospital mortality. Multivariate Cox regression analysis indicated that an increase of 1 in the CRP/albumin ratio was associated with a 15.3% increase in the risk of intra-hospital mortality (hazard ratio = 1.153, 95% CI = 1.005–1.322, p = 0.42). Furthermore, a CRP/albumin ratio cut-off value greater than 1.22 was associated with increased intra-hospital mortality (Youden’s Index = 0.19, sensitivity = 28.8, specificity = 89.9, p = 0.007). Conclusions: A CRP/albumin ratio greater than 1.22 upon admission was significantly associated with intra-hospital mortality in the ICH patients.
Highlights
Prediction of intra-hospital mortality in patients with spontaneous intracerebral hemorrhage (ICH) is still a challenging measure for health professionals
Multivariate regression analysis shows that higher C-reactive protein (CRP)/albumin ratio (odds ratio (OR) = 1.66, 95% confidence interval (CI) = 1.193–2.317, p = 0.003) upon admission is an independent predictor of intra-hospital mortality
This study revealed an increase in the CRP/albumin ratio upon admission as an independent predictor of intra-hospital mortality among ICH patients admitted to the neurosurgical intensive care units (ICU)
Summary
Prediction of intra-hospital mortality in patients with spontaneous intracerebral hemorrhage (ICH) is still a challenging measure for health professionals. Neurological deterioration due to expansion of ICH occurs in up to 30% of the patients within the first 24 hours This period of ICU treatment is essential for the determination of patient prognosis. The association between CRP/albumin ratio upon admission and intra-hospital mortality is still unknown among the patients with ICH admitted to neurosurgical ICUs. Early identification of ICH patients with a high risk for intra-hospital mortality could be useful to estimate the patient prognosis and determine the future directions for ICU treatments. Identification of ICH patients with a high risk for intra-hospital mortality could be useful to estimate the patient prognosis and determine the future directions for ICU treatments With this background in mind, the current study was conducted to investigate the impact of CRP/albumin ratio, as an early serum biomarker, on intra-hospital mortality among neurosurgical ICU-admitted patients with spontaneous ICH
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