C-reactive protein-to-serum albumin ratio as a marker of prognosis in adult intensive care population

Abstract

BACKGROUND: Patients in intensive care unit (ICU) require close follow up and clinical attention due to variability in the course of their underlying morbidities. The estimation of prognosis in these subjects has an utmost importance. Recent studies showed that C-reactive protein-to-serum albumin ratio (CAR) could be a reliable marker of infl ammation in certain conditions. We aimed to compare CAR levels of deceased patients to those in survived subjects treated in ICU. PATIENTS AND METHODS: We retrospectively analyzed the data of adult patients. CAR was simply calculated by dividing the levels of CRP by those of serum albumin. Patients were grouped either as deceased or survived according to the prognosis. The data of the survived and deceased ICU subjects were compared. RESULTS: A total of 208 subjects, 101 deceased and 107 survived, were enrolled in the study. Median CAR levels of the deceased and survived subjects were 49.5 (3–153 %) and 11 (0.2–119 %), respectively (p < 0.001). CAR was signifi cantly correlated with PDW (r = 0.24; p < 0.001) and serum creatinine (r = 0.27; p < 0.001) levels. In ROC analysis, CAR values higher than 30.2 % have 72 % sensitivity and 70 % specifi city in predicting mortality in ICU population (AUC: 0.74; p < 0.001; 95% CI: 0.67–0.81). CONCLUSIONS: We suggest that CAR levels of the subjects in ICU should be evaluated during medical care. Increased CAR levels should alert physicians for a worse outcome in those subjects (Tab. 1, Fig. 1, Ref. 21). Text in PDF www.elis.sk