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

Cao, Fan; Chen, Xinxin; Huang, Guodong; Liu, Wenhua; Zhou, Na; Yuan, Huili; Zou, Ming‐Hui

doi:10.3389/fped.2021.682839

Cited by 6 publications

(6 citation statements)

References 40 publications

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“…However, study by Godinez-Vidal et al reported that albumin can be considered a predictor of severity, although not a predictor of mortality [ 34 ]. Serum fibrinogen expression is notably increased in patients with a high inflammatory status and can promote the activation of coagulation and aggregation of PLT [ 16 , 35 ]. Previous studies have shown that dysregulation of fibrinogen expression leads to a poor prognosis of disseminated intravascular coagulation in patients with sepsis [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…AFR, the ratio of albumin to fibrinogen, can be used as a timely indicator of the nutritional status, inflammatory status, and coagulation function of patients [36][37][38] and is also an effective marker to predict the prognosis of various diseases, including lung cancer, rheumatoid arthritis, and acute kidney injury [16,36,39]. The prognosis of sepsis is closely associated with nutritional status, inflammatory status, and coagulation function of patients [4].…”

Section: Mediators Of Inflammationmentioning

confidence: 99%

“…Studies have shown that the index integrating albumin and fibrinogen, e.g., albumin-to-fibrinogen ratio (AFR), presents not only the status of inflammation and nutrition but also the coagulation function. With improved consistency compared to albumin or fibrinogen alone, AFR could amplify the sensitivity of inflammatory status and is superior in assessing the prognostic value of various diseases [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of Albumin-to-Fibrinogen Ratio for 28-Day Mortality among Patients with Sepsis from Various Infection Sites

Shen

Chang

et al. 2022

Mediators of Inflammation

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Purpose. This study investigated the prognostic value of the albumin-to-fibrinogen ratio (AFR) in patients with sepsis as a consequence of infection at various sites. Methods. A total of 300 patients with sepsis caused by various infection sites, who met the diagnostic criteria for sepsis hospitalized in the intensive care unit, were enrolled in this study. The observational endpoint was 28-day mortality. Cox proportional hazard regression analysis was performed to determine the potential prognostic factors for 28-day mortality in these septic patients. Receiver operating characteristic (ROC) curve analysis was used to evaluate and compare the prognostic factors for 28-day mortality. Results. Of 300 participants, 147 died, corresponding to a 28-day mortality of 49% (147/300). Baseline Acute Physiology and Chronic Health Evaluation (APACHE II) score (hazard ratio (HR) 1.18 (95% confidence interval (CI) 1.07–1.30); P < 0.001 ), baseline lactic acid level (HR 1.27 (95% CI 1.08–1.50); P = 0.005 ), the presence of septic shock (HR 21.44 (95% CI 2.51–182.76); P = 0.005 ), and baseline AFR (HR 0.70 (95% CI 0.62–0.80); P < 0.001 ) were independent prognostic factors for 28-day mortality in patients with sepsis according to multivariate Cox analysis. Baseline AFR was an effective predictor of 28-day mortality, with an area under the ROC curve (AUC) of 0.700, and a specificity and sensitivity of 90.8% and 42.1%, respectively. A low baseline AFR level was associated with increased 28-day sepsis-related mortality. The quadruple index, which included the APACHE II score, lactic acid, septic shock, and AFR, showed a more accurate predictive value for septic patients than the APACHE II score, lactic acid, septic shock, and AFR alone, with an AUC of 0.922, and specificity and sensitivity of 86.9% and 83.6%, respectively. Moreover, the triple index, which included the APACHE II score, lactic acid, and septic shock, showed a significantly lower prognostic value for 28-day mortality compared with the ROC curve of the quadruple index and triple index, with an AUC of 0.877 and specificity and sensitivity of 77.8% and 82.3%, respectively. Conclusions. The results of this study demonstrate that AFR is an independent protective factor for predicting 28-day mortality in patients with sepsis due to various infection sites. AFR combined with the APACHE II score, lactic acid, and septic shock showed a higher prognostic value for sepsis prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Mediators Of Inflammationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of Albumin-to-Fibrinogen Ratio for 28-Day Mortality among Patients with Sepsis from Various Infection Sites

Shen

Chang

et al. 2022

Mediators of Inflammation

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“…The innovative inflammation-based risk metric, known as the fibrinogen-to-albumin ratio (FAR), has demonstrated its value in predicting adverse outcomes in cancer ( 9 , 10 ) and cardiovascular disease ( 11 – 13 ). Recent studies has indicated that the levels of preprocedural FAR exhibit a correlation with the incidence of AKI in individuals undergoing emergency percutaneous coronary intervention ( 14 ) and elective percutaneous coronary intervention ( 15 ) and in children following ventricular septal defect surgery ( 16 ). Nevertheless, the association linking the frequency of acute kidney injury (AKI) in individuals who have undergone cardiac surgery and the previously unexplored variable, known as FAR, remains uninvestigated.…”

Section: Introductionmentioning

confidence: 99%

Prediction of acute kidney injury after cardiac surgery with fibrinogen-to-albumin ratio: a prospective observational study

Xu,

Ouyang,

Lin

et al. 2024

Front. Cardiovasc. Med.

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BackgroundThe occurrence of acute kidney injury (AKI) following cardiac surgery is common and linked to unfavorable consequences while identifying it in its early stages remains a challenge. The aim of this research was to examine whether the fibrinogen-to-albumin ratio (FAR), an innovative inflammation-related risk indicator, has the ability to predict the development of AKI in individuals after cardiac surgery.MethodsPatients who underwent cardiac surgery from February 2023 to March 2023 and were admitted to the Cardiac Surgery Intensive Care Unit of a tertiary teaching hospital were included in this prospective observational study. AKI was defined according to the KDIGO criteria. To assess the diagnostic value of the FAR in predicting AKI, calculations were performed for the area under the receiver operating characteristic curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI).ResultsOf the 260 enrolled patients, 85 developed AKI with an incidence of 32.7%. Based on the multivariate logistic analyses, FAR at admission [odds ratio (OR), 1.197; 95% confidence interval (CI), 1.064–1.347, p = 0.003] was an independent risk factor for AKI. The receiver operating characteristic (ROC) curve indicated that FAR on admission was a significant predictor of AKI [AUC, 0.685, 95% CI: 0.616–0.754]. Although the AUC-ROC of the prediction model was not substantially improved by adding FAR, continuous NRI and IDI were significantly improved.ConclusionsFAR is independently associated with the occurrence of AKI after cardiac surgery and can significantly improve AKI prediction over the clinical prediction model.

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“…Especially when combined with albumin, the albuminfibrinogen-ratio (AFR), was demonstrated to improve the prognostic accuracy as compared to albumin or fibrinogen alone within various clinical conditions [14][15][16]. Albumin is produced in the liver and is responsible for the maintenance of colloid osmotic pressure.…”

Section: Introductionmentioning

confidence: 99%

Fibrinogen reflects severity and predicts outcomes in patients with sepsis and septic shock

Schupp

Weidner

Rusnak

et al. 2023

Blood Coagulation &Amp; Fibrinolysis

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The study investigates the diagnostic and prognostic value of fibrinogen and the albumin-to-fibrinogen-ratio (AFR) in patients with sepsis and septic shock. Limited data regarding the prognostic value of fibrinogen and AFR during the course of sepsis or septic shock are available. Consecutive patients with sepsis and septic shock from 2019 to 2021 were included monocentrically. Blood samples were retrieved from the day of disease onset (day 1), as well as on day 2 and 3. Firstly, the diagnostic value of fibrinogen and the AFR for the diagnosis of a septic shock was tested. Secondly, the prognostic value of fibrinogen and AFR was tested with regard to the 30-day all-cause mortality. Statistical analyses included univariable t-tests, Spearman's correlations, C-statistics, Kaplan-Meier and multivariable Cox regression analyses. Ninety-one patients with sepsis and septic shock were included. With an area under the curve (AUC) of 0.653-0.801, fibrinogen discriminated patients with septic shock from those with sepsis. In the septic shock group, fibrinogen levels were shown to decrease from day 1 to 3 (median decrease 41%). In line, fibrinogen was a reliable predictor for 30-day allcause mortality (AUC 0.661-0.744), whereas fibrinogen levels less than 3.6 g/l were associated with an increased risk of 30-day all-cause mortality (78 vs. 53%; log rank P U 0.004; hazard ratio U 2.073; 95% confidence interval 1.233-3.486; P U 0.006), which was still observed after multivariable adjustment. In contrast, the AFR was no longer associated with the risk of mortality after multivariable adjustment. Fibrinogen was a reliable diagnostic and prognostic tool for the diagnosis of septic shock as well as for 30-day all-cause mortality and superior compared with the AFR in patients admitted with sepsis or septic shock.

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

Cited by 6 publications

References 40 publications

Prognostic Value of Albumin-to-Fibrinogen Ratio for 28-Day Mortality among Patients with Sepsis from Various Infection Sites

Prognostic Value of Albumin-to-Fibrinogen Ratio for 28-Day Mortality among Patients with Sepsis from Various Infection Sites

Prediction of acute kidney injury after cardiac surgery with fibrinogen-to-albumin ratio: a prospective observational study

Fibrinogen reflects severity and predicts outcomes in patients with sepsis and septic shock

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