Min Bai1,2, Yongming Wu1, Zhong Ji1, Shengnan Wang1, Zhenzhou Lin1, Suyue Pan1, Kaibin Huang3. 1. Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China. 2. Department of Neurology, The People's Hospital of Dali Prefecture, Dali, China. 3. Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China - hkb@smu.edu.cn.
Abstract
BACKGROUND: The C-reactive protein (CRP)/albumin ratio has been regarded as an outcome predictor in patients with cancer and sepsis. In this study, we evaluated the prognostic value of the CRP/albumin ratio in neurocritically ill patients. METHODS: We retrospectively reviewed consecutive patients admitted to the neurocritical care unit (NCU) of a university-affiliated hospital, between January 2013 and January 2017. The CRP/albumin ratio was calculated by dividing the CRP level by the albumin concentration that was obtained at NCU admission. Univariable and multivariable logistic regression were used to identify risk factors for 30-day unfavorable outcome (modified Rankin Scale of 4 to 6). The performance of the CRP/albumin ratio was further assessed by receiver operating characteristic (ROC) curve analysis. RESULTS: Of the 701 patients included, 398 (56.8%) had unfavorable outcome at 30 days. The median (interquartile range) value of the CRP/albumin ratio was noticeably higher in the unfavorable outcome group (0.9 [0.2-2.5]) than that in the favorable group (0.3 [0.1-1.2]). After adjustment for established prognostic markers of outcome, the CRP/albumin ratio (OR 1.205; 95% CI: 1.082-1.344) remained significant in predicting 30-day unfavorable outcome, with an area under the ROC curve of 0.644 and a cutoff value of 0.58. Further exploration showed that the prognostic value of the CRP/albumin ratio existed mainly in patients suffering septic shock (OR 1.616; 95% CI: 1.167-2.236), with an area under the ROC curve of 0.672 and a cutoff value of 1.75. CONCLUSIONS: A high CRP/albumin ratio at NCU admission was an independent predictor of 30-day unfavorable outcome in neurocritically ill patients, especially in those suffering septic shock.
BACKGROUND: The C-reactive protein (CRP)/albumin ratio has been regarded as an outcome predictor in patients with cancer and sepsis. In this study, we evaluated the prognostic value of the CRP/albumin ratio in neurocritically illpatients. METHODS: We retrospectively reviewed consecutive patients admitted to the neurocritical care unit (NCU) of a university-affiliated hospital, between January 2013 and January 2017. The CRP/albumin ratio was calculated by dividing the CRP level by the albumin concentration that was obtained at NCU admission. Univariable and multivariable logistic regression were used to identify risk factors for 30-day unfavorable outcome (modified Rankin Scale of 4 to 6). The performance of the CRP/albumin ratio was further assessed by receiver operating characteristic (ROC) curve analysis. RESULTS: Of the 701 patients included, 398 (56.8%) had unfavorable outcome at 30 days. The median (interquartile range) value of the CRP/albumin ratio was noticeably higher in the unfavorable outcome group (0.9 [0.2-2.5]) than that in the favorable group (0.3 [0.1-1.2]). After adjustment for established prognostic markers of outcome, the CRP/albumin ratio (OR 1.205; 95% CI: 1.082-1.344) remained significant in predicting 30-day unfavorable outcome, with an area under the ROC curve of 0.644 and a cutoff value of 0.58. Further exploration showed that the prognostic value of the CRP/albumin ratio existed mainly in patients suffering septic shock (OR 1.616; 95% CI: 1.167-2.236), with an area under the ROC curve of 0.672 and a cutoff value of 1.75. CONCLUSIONS: A high CRP/albumin ratio at NCU admission was an independent predictor of 30-day unfavorable outcome in neurocritically illpatients, especially in those suffering septic shock.
Authors: Hernán J Zavalaga-Zegarra; Juan J Palomino-Gutierrez; Juan R Ulloque-Badaracco; Melany D Mosquera-Rojas; Enrique A Hernandez-Bustamante; Esteban A Alarcon-Braga; Vicente A Benites-Zapata; Percy Herrera-Añazco; Adrian V Hernandez Journal: Trop Med Infect Dis Date: 2022-08-16