The C-Reactive Protein/Albumin Ratio as a Predictor of Mortality in Critically Ill Patients

• Published in: Journal of clinical medicine 2018-10, Vol.7 (10), p.333
• Main Authors: Park, Ji Eun, Chung, Kyung Soo, Song, Joo Han, Kim, Song Yee, Kim, Eun Young, Jung, Ji Ye, Kang, Young Ae, Park, Moo Suk, Kim, Young Sam, Chang, Joon, Leem, Ah Young
• Format: Article
• Language: English
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm7100333

The C-reactive protein (CRP)/albumin ratio has recently emerged as a marker for poor prognosis or mortality across various patient groups. This study aimed to identify the association between CRP/albumin ratio and 28-day mortality and predict the accuracy of CRP/albumin ratio for 28-day mortality in medical intensive care unit (ICU) patients. This was a retrospective cohort study of 875 patients. We evaluated the prognostic value of CRP/albumin ratio to predict mortality at 28 days after ICU admission, using Cox proportional hazard model and Kaplan-Meier survival analysis. The 28-day mortality was 28.0%. In the univariate analysis, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score ( < 0.001), CRP level ( = 0.045), albumin level ( < 0.001), and CRP/albumin ratio ( = 0.032) were related to 28-day mortality. The area under the receiver operating characteristic (ROC) curve (the area under the ROC curves (AUC)) of CRP/albumin ratio was higher than that of CRP for mortality (0.594 vs. 0.567, < 0.001). The cut-off point for CRP/albumin ratio for mortality was 34.3. On Cox proportional-hazard regression analysis, APACHE II score (hazards ratio (HR) = 1.05, 95% confidence interval (CI) = 1.04⁻1.07, < 0.001) and CRP/albumin ratio (HR = 1.68, 95% CI = 1.27⁻2.21, < 0.001 for high CRP/albumin ratio) were independent predictors of 28-day mortality. Higher CRP/albumin ratio was associated with increased mortality in critically ill patients.