Predictive Value of the C-Reactive Protein-To-Prealbumin Ratio in Medical ICU Patients

Li, Li; Dai, Li-Yang; Wang, Xiao; Wang, Yao; Zhou, Long; Miao, Chen; Wang, Hairong

doi:10.2217/bmm-2016-0266

Cited by 37 publications

(35 citation statements)

References 33 publications

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“…The current study revealed poor association between CRP/albumin ratio and PICU stay. Compared with our finding in pediatric patients, Li et al 28 have demonstrated significantly increased total length of hospital stay in adult patients admitted to medical ICU with CRP/prealbumin more than 0.24. Another study has reported a significantly higher CRP/prealbumin in ICU adult patients with severe pancreatitis who had a longer period of ICU stay.…”

Section: Discussioncontrasting

confidence: 99%

C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Critically Ill Pediatric Patients

Mohamed

Hawary

2020

Journal of Child Science

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It is necessary to stratify the risk of pediatric patients at the time of intensive care unit (ICU) admission and to predict their outcomes. This helps to allocate the scarce ICU resources to start the appropriate treatment. The objective of this study was to evaluate the prognostic value of C-reactive protein/albumin ratio on admission to pediatric intensive care unit (PICU) in predicting mortality, PICU length of stay, the need for mechanical ventilation, and the use of inotropic drugs. This cohort study was conducted at Pediatric Cairo University Hospital. The study included 178 critically ill children. Pediatric Risk of Mortality–III (PRISM-III) score was calculated; CRP and serum albumin levels were assessed within 24 hours from admission. The median CRP/albumin ratio was significantly higher in nonsurvivors than survivors (18.60 and 4.65, respectively). The CRP/albumin ratio at a cutoff of ≥25.83 had significant discriminatory power in predicting mortality (area under the curve [AUC] = 0.795 and p < 0.001) with 85.4% accuracy. Furthermore, CRP/albumin ratio alone showed a comparable discriminatory power to that of PRISM-III score (AUCs = 0.795 and 0.793, respectively). A multivariable logistic regression analysis revealed that each unit of increase in the CRP/albumin ratio increased the risk of mortality by 1.075 (odds ratio [OR] = 1.075). CRP/albumin ratio showed a significantly higher median in ventilated (6.86) compared with non-ventilated (5.22) patients. Patients supported with inotropes showed significantly higher median CRP/albumin ratio (11.70 and 3.68, respectively). CRP/albumin ratio at admission to PICU was a good independent predictor of mortality.

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Section: Discussioncontrasting

confidence: 99%

C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Critically Ill Pediatric Patients

Mohamed

Hawary

2020

Journal of Child Science

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“…However, using of hs-CRP alone to predict MACE in patients with ACS may be limited. Inflammation can induce malnutrition, which may exert a negative effect on the management of inflammation 18 . PAB as a parameter in the evaluation of nourishment state was suppressed in an inflammatory environment 10 .…”

Section: Discussionmentioning

confidence: 99%

High sensitivity C-reactive protein to prealbumin ratio measurement as a marker of the prognosis in acute coronary syndrome

Wang

Ren

Wang

et al. 2019

Sci Rep

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The study aimed to determine whether high sensitivity C-reactive protein to prealbumin (hs-CRP/PAB) ratio could be used to predict in-hospital major adverse cardiac events (MACE) in patients with acute coronary syndrome (ACS). A total of 659 patients with ACS were included in the study. Patients were divided into two groups: high hs-CRP/PAB ratio group (hs-CRP/PAB ≥0.010) and low hs-CRP/PAB ratio group (hs-CRP/PAB <0.010). MACE was defined as death, cardiogenic shock, re-infarction and acute heart failure. Logistic regression was performed and the receiver operating characteristic curve (ROC) was generated to evaluate the correlation of hs-CRP/PAB ratio and MACE in patients with ACS. The occurrence rate of MACE was significantly higher in high hs-CRP/PAB ratio group when compared with that in low hs-CRP/PAB ratio group ( P < 0.001). Multivariable analysis determined that hs-CRP/PAB ratio was an independent predictor of MACE (adjusted odds ratio: 1.276, 95% confidence interval: 1.106–1.471, P = 0.001). Moreover, the area under the curve value of hs-CRP/PAB ratio for predicting MACE was higher than hs-CRP and equal to PAB. High hs-CRP/PAB ratio was considered as a prognostic parameter of MACE in ACS patients, with the predictive power equal to PAB but greater than hs-CRP.

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“…An increase in the C-reactive protein/prealbumin ratio in medical intensive care unit patients has been associated with mortality [35], and a low C-reactive protein/prealbumin ratio in surgical patients predicted the successful closure of gastrointestinal fistulas [36]. Routine measurement of prealbumin has been advocated to be a useful nutritional and prognostic indicator in non-ICU patients without inflammation [34].…”

Section: Serum Visceral Proteins As Biomarkers Of the Nutritional mentioning

confidence: 99%

Nutritional Laboratory Markers in Malnutrition

Keller¹

2019

JCM

454

353

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Serum visceral proteins such as albumin and prealbumin have traditionally been used as markers of the nutritional status of patients. Prealbumin is nowadays often preferred over albumin due to its shorter half live, reflecting more rapid changes of the nutritional state. However, recent focus has been on an appropriate nutrition-focused physical examination and on the patient’s history for diagnosing malnutrition, and the role of inflammation as a risk factor for malnutrition has been more and more recognized. Inflammatory signals are potent inhibitors of visceral protein synthesis, and the use of these proteins as biomarkers of the nutritional status has been debated since they are strongly influenced by inflammation and less so by protein energy stores. The current consensus is that laboratory markers could be used as a complement to a thorough physical examination. Other markers of the nutritional status such as urinary creatinine or 3-methylhistidine as indicators of muscle protein breakdown have not found widespread use. Serum IGF-1 is less influenced by inflammation and falls during malnutrition. However, its concentration changes are not sufficiently specific to be useful clinically as a marker of malnutrition, and serum IGF-1 has less been used in clinical trials. Nevertheless, biomarkers of malnutrition such as prealbumin may be of interest as easily measurable predictors of the prognosis for surgical outcomes and of mortality in severe illnesses.

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Predictive Value of the C-Reactive Protein-To-Prealbumin Ratio in Medical ICU Patients

Abstract: CRP/PAB were independently correlated with hospital mortality and TLSH in medical intensive care unit.

Cited by 37 publications

References 33 publications

C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Critically Ill Pediatric Patients

C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Critically Ill Pediatric Patients

High sensitivity C-reactive protein to prealbumin ratio measurement as a marker of the prognosis in acute coronary syndrome

Nutritional Laboratory Markers in Malnutrition

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