Klinička i prediktivna vrijednost omjera C-reaktivnog protein/albumina u kritičnih, mehanički ventiliranih bolesnika

Abstract

Introduction: CPR/albumin ratio represents a new biomarker that integrates two laboratory-tested acute phase reactants: a positive one (C-reactive protein) and a negative one (albumin), and which can be used as an indicator of the severity, progression and outcome of various illnesses, including critical illnesses. In this retrospective study, we investigated the impact of the CRP/albumin ratio on the clinical characteristics and outcome of the treatment of critically ill and mechanically ventilated adult patients. Patients and methods: This retrospective study included 100 critically ill patients (65 % males and 35 % females; median age of 67) treated at the medical intensive care unit (ICU) which required the use of invasive mechanical ventilation. The primary diagnoses upon admission to the intensive care unit were: sepsis and septic shock (39 %), acute heart failure or worsening chronic heart failure (20 %), exacerbation of chronic obstructive pulmonary disease (16 %), pneumonia (11 %), acute kidney injury or the exacerbation of chronic kidney disease (7 %) and other conditions (7 %). Results: Correlation analysis showed a significant moderate positive correlation between CRP/albumin ratio and the duration of mechanical ventilation measured in hours (r = 0.48, p = 0.001) and the time spent in the intensive care unit, measured in days (r = 0.44, p = 0.001). The median of the CRP/albumin ratio was 58.77 and the patients in the above-the-median group had a higher SOFA score. In terms of the outcomes, it has been determined that the surviving patients (56 %) had a significantly lower CRP/albumin ratio compared to those that had not survived (44 %), which correlates with their SOFA scores as well. In the group of survivors, the correlation between the ratio of CRP/albumin and the SOFA score is positive and statistically significant (r = 0.29, p = 0.03), in the group non-survivoris (r= 0.45, p = 0.003.) Conclusion: Based on the results of our study, the CRP/albumin ratio has proved to be a good predictor of clinical characteristics and outcomes of critically ill and mechanically ventilated patients.