Association between alkaline phosphatase to albumin ratio and mortality among patients with sepsis

Abstract

The alkaline phosphatase-to-albumin ratio (APAR) is correlated to worse prognosis in coronary artery disease, cancer, and acute renal failure. However, the relationship between APAR and sepsis prognosis has received little research. The content of this research was to investigate the prognostic relationship between APAR and sepsis. And validate the stability of the correlation in 90-days and 1-year mortality. Retrospective cohort research was conducted basing MIMIC-IV database (version 2.0). The hazard ratio (HR) and 95% confidence interval (Cl) were computed using multivariate Cox regression analysis. In addition, plots of survival curves and subgroup analyzes were conducted. Receiver operating characteristic (ROC) curves were also used. 9741 participants were included in this investigation. The 90-days mortality was 32.8%, and the 1-year mortality was 42.0%. After controlling for confounders, the adjusted HRs (95% CI) for tertile 2 (2.2–3.8) and tertile 3 (> 3.8) were 1.37 (1.25–1.51) and 1.74 (1.58–1.91), respectively. The Kaplan–Meier curve analysis showed a higher probability of 90-days death in the higher APAR group. The area under the curve (AUC) of APAR was 0.674 and could reach 0.709 after combining the Oxford Acute Severity of Illness Score (OASIS). This study demonstrates that APAR is significantly related to bad clinical outcomes in sepsis.

Non-linear Association of Alkaline Phosphatase-to-Albumin Ratio with All-Cause and Cancer Mortality: Evidence from NHANES 2005-2016

“…Additionally, a study conducted by Liu et al demonstrated that APAR was independently associated with mortality in patients with sepsis [14]. Moreover, higher APAR levels were independently associated to increased cancer mortality as reported, including lung cancer [7,8,11], hepatocellular carcinoma [6], pancreatic ductal adenocarcinoma [9,20], nasopharyngeal carcinoma [12], urothelial carcinoma [13], and some other types [22][23][24][25][26][27][28][29].…”

“…The ALP-to-ALB ratio (APAR), a novel prognostic marker amalgamating ALP and ALB, has been proposed and exhibits promising prognostic value in various cancers and other diseases [6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Moreover, APAR exhibits superior predictive performance for clinical outcomes when compared with independent ALP and ALB measurements [20].…”