C-reactive protein/albumin ratio predicts 90-day mortality of septic patients.
C-reactive protein/albumin ratio predicts 90-day mortality of septic patients.
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DOI：
10.1371/journal.pone.0059321
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Park M
中科院分区：
文献类型：
--
作者：
Ranzani OT;Zampieri FG;Forte DN;Azevedo LC;Park M
ICU出院时的残余炎症可能会影响长期死亡率。然而，持续炎症对ICU出院后死亡率的重要性描述不多。C-反应蛋白（CRP）和白蛋白在ICU中经常测量，并在炎症期间表现出相反的模式。由于感染是炎症的潜在触发因素，我们假设出院时CRP水平与脓毒症患者的长期死亡率相关，并且CRP/白蛋白比值是比单独CRP更好的预后标志物。我们评估了334例因严重脓毒症或脓毒性休克而入住ICU的患者，这些患者在ICU至少72小时后活着出院。我们评估了CRP和CRP/白蛋白预测ICU出院后90天死亡率的性能。基于出院时的测量值生成两个多变量logistic模型：一个模型包括CRP（模型-CRP），另一个包括CRP/白蛋白比值（模型-CRP/白蛋白）。分别有229例（67%）和111例（33%）患者发生严重脓毒症和脓毒性休克。在90天的随访中，73例（22%）患者死亡。入院和出院时CRP/白蛋白比值与不良结局相关，在这些时间点显示出比单独CRP更高的准确性（分别为p= 0.0455和p =0.0438）。 CRP水平和CRP/白蛋白比值是90天时死亡率的独立预测因子（模型-CRP：校正OR 2.34，95% CI 1.14-4.83，p = 0.021;模型-CRP/白蛋白：校正OR 2.18，95% CI 1.10-4.67，p = 0.035）。 两种模型显示出相似的准确性（p = 0.2483）。 然而，模型-CRP未校准。使用CRP/白蛋白比值评估ICU出院时的残余炎症是脓毒症患者90天死亡率的独立危险因素。使用CRP/白蛋白比值作为预后的长期标志物比单独使用标准CRP值提供了更一致的结果。
Residual inflammation at ICU discharge may have impact upon long-term mortality. However, the significance of ongoing inflammation on mortality after ICU discharge is poorly described. C-reactive protein (CRP) and albumin are measured frequently in the ICU and exhibit opposing patterns during inflammation. Since infection is a potent trigger of inflammation, we hypothesized that CRP levels at discharge would correlate with long-term mortality in septic patients and that the CRP/albumin ratio would be a better marker of prognosis than CRP alone. We evaluated 334 patients admitted to the ICU as a result of severe sepsis or septic shock who were discharged alive after a minimum of 72 hours in the ICU. We evaluated the performance of both CRP and CRP/albumin to predict mortality at 90 days after ICU discharge. Two multivariate logistic models were generated based on measurements at discharge: one model included CRP (Model-CRP), and the other included the CRP/albumin ratio (Model-CRP/albumin). There were 229 (67%) and 111 (33%) patients with severe sepsis and septic shock, respectively. During the 90 days of follow-up, 73 (22%) patients died. CRP/albumin ratios at admission and at discharge were associated with a poor outcome and showed greater accuracy than CRP alone at these time points (p = 0.0455 and p = 0.0438, respectively). CRP levels and the CRP/albumin ratio were independent predictors of mortality at 90 days (Model-CRP: adjusted OR 2.34, 95% CI 1.14–4.83, p = 0.021; Model-CRP/albumin: adjusted OR 2.18, 95% CI 1.10–4.67, p = 0.035). Both models showed similar accuracy (p = 0.2483). However, Model-CRP was not calibrated. Residual inflammation at ICU discharge assessed using the CRP/albumin ratio is an independent risk factor for mortality at 90 days in septic patients. The use of the CRP/albumin ratio as a long-term marker of prognosis provides more consistent results than standard CRP values alone.
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影响因子：
38.9
作者：
Ho, Kwok M.;Lee, Koky Y.;Webb, Steven A. R.
通讯作者：
Webb, Steven A. R.
影响因子：
37.8
作者：
Cook, Nancy R.
通讯作者：
Cook, Nancy R.
影响因子：
9.8
作者：
Al-Subaie, N.;Reynolds, T.;Hall, G. M.
通讯作者：
Hall, G. M.
DOI：
10.1111/j.1532-5415.2008.01677.x
发表时间：
2008-05-01
影响因子：
6.3
作者：
Carriere, Isabelle;Dupuy, Anne-Marie;Delcourt, Cecile
通讯作者：
Delcourt, Cecile
影响因子：
3.7
作者：
Ho, Kwok M.;Dobb, Geoffrey J.;Webb, Steven A. R.
通讯作者：
Webb, Steven A. R.