Albumin-to-Fibrinogen Ratio Independently Predicts 28-Day Mortality in Patients with Peritonitis-Induced Sepsis

Abstract

Background. This study is aimed at investigating whether albumin-to-fibrinogen ratio (AFR) could independently predict the prognosis in patients with peritonitis-induced sepsis. Methods. A total of 246 eligible patients who were scheduled to undergo surgical treatment for peritonitis-induced sepsis were enrolled in this study. The primary observational endpoint was 28-day hospital mortality. Cox proportional hazards regression analysis with the Wald test was performed to identify prognostic factors for 28-day mortality in septic patients. Receiver operating characteristic (ROC) and Kaplan-Meier curve analyses were carried out to evaluate the association of baseline AFR and prognosis in septic patients. Results. Of all the cohort study participants, there were 59 nonsurvivors with a 28-day mortality of 24.0% (59/246). Baseline AFR (hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.42–0.93, P=0.018) and the presence of septic shock (HR: 2.43, 95% CI: 1.42–3.91, P=0.021) were two independent prognostic factors for 28-day mortality in patients with peritonitis-induced sepsis by multivariate Cox analysis. Baseline AFR was a significant predictor for 28-day mortality with an area under the curve (AUC) of 0.751, a cut-off value of 8.85, a sensitivity of 66.10%, and a specificity of 70.05%, respectively (95% CI: 0.688–0.813, P<0.001). A low baseline AFR level (≤8.85) was significantly associated with a lower overall survival rate in septic patients by Kaplan-Meier curve analysis with log-rank test (P=0.004). Conclusions. This study indicates that AFR independently predicts 28-day mortality in patients with peritonitis-induced sepsis.

Novel serological biomarkers for inflammation in predicting disease severity in patients with COVID-19

“…Severe or critically ill COVID-19 patients exhibit extreme systemic inflammation and poor nutritional status [8] , [9] . Serological biomarkers, including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), derived neutrophil-lymphocyte ratio (dNLR), high sensitivity C-reactive protein-albumin ratio (HsCAR), albumin-to-fibrinogen ratio (AFR), prognostic nutritional index (PNI), systemic immune-inflammation index (SII), and high sensitivity C-reactive protein-prealbumin ratio (HsCPAR), are indicators of systematic inflammation and nutritional status and function as prognostic factors for malignancies and inflammatory disease [11] , [12] , [13] . However, how these serological biomarkers change in the peripheral blood and their clinical values in COVID-19 remain unclear.…”

Pretreatment Albumin-to-Fibrinogen Ratio Independently Predicts Chemotherapy Response and Prognosis in Patients with Locally Advanced Rectal Cancer Undergoing Total Mesorectal Excision After Neoadjuvant Chemoradiotherapy

“…AFR, which combines these two biomarkers, has attracted a lot of attention in recent decades. Recently, accumulating evidence has verified the prognostic value of AFR in various diseases, including peritonitis-induced sepsis, 28 non-small-cell lung cancer after platinum-based chemotherapy, 29 and advanced epithelial ovarian cancer. 30 In addition, some other biomarkers reflecting systematic inflammatory status, such as CRP, and neutrophil-to-lymphocyte ratio (NLR), have also shown prognostic values in malignancies.…”

The Albumin-to-Fibrinogen Ratio Independently Predicts Acute Kidney Injury in Infants With Ventricular Septal Defect Undergoing Cardiac Surgery With Cardiopulmonary Bypass

“…Fibrinogen (Fib), an essential protein in coagulation, is also widely recognized as a sensitive index for inflammatory status ( 12 ). Alb-to-Fib ratio (AFR), which combines Alb and Fib, has been used as prognostic factors for different classes of diseases, including peritonitis-induced sepsis ( 13 ), advanced epithelial ovarian cancer ( 14 ), untreated chronic lymphocytic leukemia ( 15 ), and nonsmall cell lung cancer ( 16 ). However, it is unknown whether AFR is able to serve as an independent prognostic marker for AKI in VSD infants after cardiac surgery with CPB.…”