C-reactive protein-to-albumin ratio as a biomarker in patients with sepsis: a novel LASSO-COX based prognostic nomogram

Abstract

To develop a C-reactive protein-to-albumin ratio (CAR)-based nomogram for predicting the risk of in-hospital death in sepsis patients. Sepsis patients were selected from the MIMIC-IV database. Independent predictors were determined by multiple Cox analysis and then integrated to predict survival. The performance of the model was evaluated using the concordance index (C-index), receiver operating characteristic curve (ROC) analysis, and calibration curve. The risk stratifications analysis and subgroup analysis of the model in overall survival (OS) were assessed by Kaplan–Meier (K–M) curves. A total of 6414 sepsis patients were included. C-index of the CAR-based model was 0.917 [standard error (SE): 0.112] for the training set and 0.935 (SE: 0.010) for the validation set. The ROC curve analysis showed that the area under the curve (AUC) of the nomogram was 0.881 in the training set and 0.801 in the validation set. And the calibration curve showed that the nomogram performs well in both the training and validation sets. K–M curves indicated that patients with high CAR had significantly higher in-hospital mortality than those with low CAR. The CAR-based model has considerably high accuracy for predicting the OS of sepsis patients.

Clinical predictive value of the CRP-albumin-lymphocyte index for prognosis of critically ill patients with sepsis in intensive care unit: a retrospective single-center observational study

“…On the other hand, immune imbalance can also result in anti-inflammatory hyperactivity and the production of anti-inflammatory cytokines, which affected immune cell functions and disrupted the body’s equilibrium. Inflammation markers were crucial indicators throughout the development of sepsis ( 39 ). CRP, a commonly used inflammatory marker in clinical practice, had been studied for its prognostic efficacy in sepsis ( 39 ).…”

“…Inflammation markers were crucial indicators throughout the development of sepsis ( 39 ). CRP, a commonly used inflammatory marker in clinical practice, had been studied for its prognostic efficacy in sepsis ( 39 ). Studies had shown that elevated CRP levels in sepsis patients were associated with increased risk of in-hospital mortality rates and short-term mortality.…”

“…Furthermore, a prospective study of 851 sepsis patients demonstrated that an admission CRP level > 100 mg/L was associated with 30-day mortality (42). Apart from inflammation, the impact of nutritional status on the occurrence and progression of sepsis should not be overlooked (39). During the acute phase of sepsis, severe infection triggered the release of a large amount of inflammatory mediators in the body, promoting the secretion of catabolic hormones such as epinephrine, cortisol, and glucagon.…”

The association between C-reactive protein to albumin ratio and 6-month neurological outcome in patients with in-hospital cardiac arrest

“…In sepsis patients, high CRP and low albumin levels are linked with outcomes. [37] Furthermore, compared with OHCA patients, IHCA patients had higher CRP and lower albumin levels, which correlated with patient outcomes. [8,32] Therefore, the distinctive high CRP and low albumin levels in IHCA patients, as opposed to those in OHCA patients, may be indicative of prognosis, aligning with the findings of the present study.…”

Hospitalised patients' albumin-globulin ratio may predict negative clinical outcomes

“…K-M curves showed higher in-hospital mortality in high CAR patients. Sepsis survival is accurately predicted by CARbased model 14. Chen J et al examined 196 advanced NSCLC patients treated with anlotinib from June 2018 to June 2021 in 2023.…”