Original scientific paper

https://doi.org/10.57140/mj.53.2.9

The clinical and predictive value of C-reactive protein/albumin ratio in critically ill and mechanically ventilated adult patients

Domagoj Loinjak ; Josip juraj Strossmayer University of Osijek, Faculty of medicine; University Hospital Centre Osijek, Department of pulmology and intensive care medicine
Damir Mihić ; Josip juraj Strossmayer University of Osijek, Faculty of medicine; University Hospital Centre Osijek, Department of pulmology and intensive care medicine
Lana Maričić ; Josip juraj Strossmayer University of Osijek, Faculty of medicine; University Hospital Centre Osijek, Department of cardiology
Marija Kadović ; Josip juraj Strossmayer University of Osijek, Faculty of medicine
Livija Sušić ; Josip juraj Strossmayer University of Osijek, Faculty of medicine
Ivana Tolj ; Josip juraj Strossmayer University of Osijek, Faculty of medicine; University Hospital Centre Osijek, Department of nephrology

Abstract

Introduction: CPR/albumin ratio represents a new biomarker that integrates two laboratory-tested
acute phase reactants: a positive one (C-reactive protein) and a negative one (albumin), and which can be
used as an indicator of the severity, progression and outcome of various illnesses, including critical
illnesses. In this retrospective study, we investigated the impact of the CRP/albumin ratio on the clinical
characteristics and outcome of the treatment of critically ill and mechanically ventilated adult patients.
Patients and methods: This retrospective study included 100 critically ill patients (65 % males and 35
% females; median age of 67) treated at the medical intensive care unit (ICU) which required the use of
invasive mechanical ventilation. The primary diagnoses upon admission to the intensive care unit were:
sepsis and septic shock (39 %), acute heart failure or worsening chronic heart failure (20 %), exacerbation
of chronic obstructive pulmonary disease (16 %), pneumonia (11 %), acute kidney injury or the
exacerbation of chronic kidney disease (7 %) and other conditions (7 %).
Results: Correlation analysis showed a significant moderate positive correlation between CRP/albumin
ratio and the duration of mechanical ventilation measured in hours (r = 0.48, p = 0.001) and the time spent
in the intensive care unit, measured in days (r = 0.44, p = 0.001). The median of the CRP/albumin ratio was
58.77 and the patients in the above-the-median group had a higher SOFA score. In terms of the outcomes,
it has been determined that the surviving patients (56 %) had a significantly lower CRP/albumin ratio
compared to those that had not survived (44 %), which correlates with their SOFA scores as well. In the
group of survivors, the correlation between the ratio of CRP/albumin and the SOFA score is positive and
statistically significant (r = 0.29, p = 0.03), in the group non-survivoris (r= 0.45, p = 0.003.)
Conclusion: Based on the results of our study, the CRP/albumin ratio has proved to be a good predictor
of clinical characteristics and outcomes of critically ill and mechanically ventilated patients.

Keywords

C-reactive protein; albumin; critically ill; outcome; mechanical ventilation

Hrčak ID:

307318

URI

https://hrcak.srce.hr/307318

Publication date:

21.8.2023.

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