Assessment of relationship between C-reactive protein to albumin ratio and 90-day mortality in patients with acute ischaemic stroke
Assessment of relationship between C-reactive protein to albumin ratio and 90-day mortality in patients with acute ischaemic stroke
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DOI：
10.5603/pjnns.a2019.0020
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发表时间：
2019-01-01
影响因子：
2.9
通讯作者：
Kocaturk, Ozcan
中科院分区：
文献类型：
--
作者：
Kocaturk, Mehtap;Kocaturk, Ozcan
研究目的和临床依据。目前已知炎症参与急性缺血性卒中（AIS）的病理生理过程。已证明CRP和白蛋白单独用于预测中风患者的预后是有用的。这两个参数的组合，即CRP与白蛋白的比率（CAR），被认为是比单独的CRP或白蛋白更准确的炎症状态指标，并且在预测缺血性卒中患者的预后方面可能比单独的CRP或白蛋白更有价值。然而，CAR作为AIS患者死亡率的预测因子的作用仍不清楚。我们回顾性招募了260名在症状出现的前24小时内被转诊到我们诊所的患者，这些患者在2015年1月至2018年12月期间被诊断为AIS。根据90天死亡率将患者组分为两组。在C反应蛋白、白蛋白和CAR方面对这些组进行比较。在非存活患者中，C反应蛋白和CAR值较高，白蛋白水平较低。CAR值也被发现是AIS患者90天死亡率的重要独立变量（p < 0.001）。CAR预测AIS患者90天死亡率的最佳截断值为0.50，敏感性为64.1%，特异性为56.2%。我们的研究表明，高CAR值是AIS患者90天死亡率的独立预测因子。
Aim and clinical rationale for the study. It is now known that inflammation is involved i n the pathophysiology of acute ischaemic stroke (AIS). It has been proven that CRP and albumin alone are useful in predicting a prognosis for stroke patients. A combination of these two parameters, namely the ratio of CRP to albumin (CAR), is believed to be a more accurate indicator of inflammatory status than CRP or albumin alone, and may be more valuable than either of them separately in predicting the prognosis of ischaemic stroke patients. However, the role of CAR as a predictor of mortality in patients with AIS remains unclear.Materials and methods. We retrospectively enrolled 260 patients who were referred to our clinic within the first 24 hours of symptom presentation and who were diagnosed with AIS between January 2015 and December 2018. The patient group was classified into two groups according to 90-day mortality. These groups were compared in terms of C-reactive protein, albumin, and CAR.Results. The C-reactive protein and CAR values were higher, and the albumin level was lower, in non-surviving patients. The CAR value was also found to be a significant independent variable of 90-day mortality in patients with AIS (p < 0.001). The optimum cut-off value of CAR in predicting the 90-day mortality for patients with AIS was 0.50, with 64.1% sensitivity and 56.2% specificity.Conclusions and clinical implications. Our study demonstrated that a high CAR value is an independent predictor of 90-day mortality in patients with AIS.