Association of Procalcitonin to Albumin Ratio with the Presence and Severity of Sepsis in Neonates

Li, Tiewei; Li, Xiaojuan; Liu, Xinrui; Zhu, Zhiwei; Zhang, Min; Xu, Zhe; Wei, Yulei; Feng, Yichuang; Qiao, Xiaoliang; Yang, Junmei; Dong, Geng

doi:10.2147/jir.s358067

“…Hypoalbuminemia could widely be seen in patients with inflammatory diseases and was associated more severe inflammation [30,31]. In terms of sepsis, studies reported that patients with sepsis had a lower level of ALB and low ALB level was associated with a poorer prognosis [35][36][37]. Compared with neonatal pneumonia, our data revealed that neonates with sepsis had a higher CRP level and a lower ALB level, indicating that CRP and ALB may have the power in identifying sepsis from nonseptic neonates with pneumonia.…”

Section: Discussionmentioning

confidence: 53%

C-Reactive Protein-to-Albumin Ratio as an Early Biomarker to Identify Sepsis in Neonates with Pneumonia

Kang

¹

,

Wen

²

,

Li

³

et al. 2022

Mediators of Inflammation

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Objectives. Neonates with pneumonia often also have sepsis, and the identifying sepsis from pneumonia may be a challenge for clinicians. However, there are no available data regarding the clinical value C-reactive protein-to-albumin ratio (CAR) in identifying sepsis in neonates with pneumonia. The aim of this study was to evaluate the clinical value of CAR in identifying sepsis in neonates with pneumonia. Methods. 847 neonates with pneumonia were included in this study, of which 511 neonates were diagnosed with sepsis. Neonates were divided into the sepsis group and the nonsepsis group. All neonates underwent extensive and necessary clinical and laboratory tests. CAR was calculated as serum C-reactive protein (ng/ml)/albumin (mg/ml). All statistical analyses were performed using the statistical package SPSS 24.0, as appropriate. Results. Compared with the nonsepsis group, neonates with sepsis have a higher CAR ( P < 0.001 ). Further analysis showed that the prevalence of neonates with sepsis increased significantly from 41.0% in the low CAR group ( CAR ≤ 0.024 × 10 − 3 ) to 80.0% in the high CAR group ( CAR > 0.024 × 10 − 3 ) ( P < 0.001 ). Correlation analysis showed that there was a strong positive correlation between CAR and PCT ( r = 0.452 , P < 0.001 ), nSOFA ( r = 0.267 , P < 0.001 ), and the prolonged length of hospital stay ( r = 0.311 , P < 0.001 ). Multiple logistic regression showed that CAR was an independent risk factor for the presence of sepsis in neonates with pneumonia. Receiver operating characteristic curve analysis revealed that CAR had adequate discriminatory power in predicting sepsis in neonates with pneumonia (area under curve AUC = 0.76 , 95% CI 0.73-0.79, P < 0.001 ). Conclusions. CAR can be used as a new marker to identify sepsis in neonates with pneumonia.

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“… 46 Sepsis patients with lower serum albumin levels are more prone to poor clinical prognosis. 47 A prospective cohort study has shown that albumin levels are an essential predictor of 28-day mortality in sepsis, with a cut-off value of 29.2g/L, indicating good sensitivity and specificity. 48 It may be related to the inflammatory response affecting vascular endothelial function, causing an increase in capillary permeability and albumin leakage to the outside of the blood vessels.…”

Section: Discussionmentioning

confidence: 99%

The Ratio of Red Blood Cell Distribution Width to Albumin as a Predictor for Rehospitalization Risk and Rehospitalization All-Cause Mortality in Middle-Aged and Elderly Survivors with Sepsis: An Ambispective ICU Cohort Study

Tan,

Li,

Huang

et al. 2024

JIR

5

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Objective To explore the relationship between red blood cell distribution width to albumin (RDW/ALB) ratio (RAR) and the risk of rehospitalization and rehospitalization all-cause mortality in middle-aged and elderly survivors with sepsis based on an ambispective longitudinal cohort from the Intensive Care Unit (ICU). Methods Between 2017 and 2022, 455 adults who survived the first-episode severe sepsis without recurrence for at least 3 months were included in this study. All participants were followed up every 4 weeks for 12 months. According to the tertiles of RAR, participants were divided into three groups: low-level (≤0.36, n = 152), moderate-level (0.37–0.44, n = 152), and high-level (≥0.45, n = 151). The relationship between RAR and the risk of rehospitalization and rehospitalization all-cause mortality was evaluated. Results Out of 455 participants, 156 experienced rehospitalization (34.3%), of which 44 (28.2%) died. Receiver operating characteristic (ROC) analysis showed that the RAR cut-off values for rehospitalization and rehospitalization all-cause mortality were 0.4251 and 0.4743, respectively. Multivariate Cox regression analysis indicated that the RAR was positively associated with rehospitalization ( P = 0.011) and all-cause mortality ( P = 0.006). Compared with the low-level, the high-level RAR presented a higher dose-dependent rehospitalization risk ( P = 0.02) and rehospitalization all-cause mortality ( P = 0.044). The stratified analysis displayed that compared to the low-level, with the RAR increasing by 1.0, the risk for rehospitalization increased 3.602-fold in aged <65 patients ( P = 0.002) and 1.721-fold in female patients ( P = 0.014). Kaplan–Meier survival analysis implied a significant positive association between the RAR and the cumulative incidence of rehospitalization and rehospitalization all-cause mortality (log-rank, all P < 0.001). Conclusion RAR has a reliable predictive value for the risk of rehospitalization and rehospitalization all-cause mortality in patients with sepsis. Consequently, monitoring RAR for at least 1 year after surviving sepsis in female patients aged <65 in clinical practice is critical.

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“…18 In sepsis, patients were more likely to have lower levels of serum albumin, which were closely associated with poor prognosis. [19][20][21] One prospective cohort study demonstrated that albumin level was an important predictor for 28-day mortality in sepsis, and 29.2g/L was the best threshold value with good sensitivity and specificity. 22 In sepsis with acute kidney injury, the albumin level was an independent indicator for both 28-day and 90-day mortality (HR = 0.75, 95% CI: 0.62-0.90 and HR = 0.73, 95% CI: 0.63-0.86, respectively) based on a retrospective study.…”

Section: Discussionmentioning

confidence: 99%

Albumin Level is Associated with Short-Term and Long-Term Outcomes in Sepsis Patients Admitted in the ICU: A Large Public Database Retrospective Research

Cao¹,

Su²,

Guo³

et al. 2023

CLEP

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Objective This study aimed to explore the relationship between albumin level with short- and long-term outcomes in sepsis patients admitted in the intensive care unit (ICU) based on a large public database to provide clinical evidence for physicians to make individualized plans of albumin supplementation. Methods Sepsis patients admitted in the ICU in MIMIC-IV were included. Different models were performed to investigate the relationships between albumin and mortalities of 28-day, 60-day, 180-day and 1-year. Smooth fitting curves were performed. Results A total of 5357 sepsis patients were included. Mortalities of 28-day, 60-day, 180-day and 1-year were 29.29% (n = 1569), 33.92% (n = 1817), 36.70% (n = 1966) and 37.71% (n = 2020). In the fully adjusted model (adjusted for all potential confounders), with each 1g/dL increment in albumin level, the risk of mortality in 28-day, 60-day, 180-day and 1-year decreased by 39% (OR = 0.61, 95% CI: 0.54–0.69), 34% (OR = 0.66, 95% CI: 0.59–0.73), 33% (OR = 0.67, 95% CI: 0.60–0.75), and 32% (OR = 0.68, 95% CI: 0.61–0.76), respectively. The non-linear negative relationships between albumin and clinical outcomes were confirmed by smooth fitting curves. The turning point of albumin level was 2.6g/dL for short- and long-term clinical outcomes. When albumin level ≤2.6g/dL, with each 1g/dL increment in albumin level, the risk of mortality in 28-day, 60-day, 180-day and 1-year decreased by 59% (OR = 0.41, 95% CI: 0.32–0.52), 62% (OR = 0.38, 95% CI: 0.30–0.48), 65% (OR = 0.35, 95% CI: 0.28–0.45), and 62% (OR = 0.38, 95% CI: 0.29–0.48), respectively. Conclusion Albumin level was associated with short- and long-term outcomes in sepsis. Albumin supplementation might be beneficial for septic patients with serum albumin<2.6g/dL.

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Association of Procalcitonin to Albumin Ratio with the Presence and Severity of Sepsis in Neonates

Cited by 14 publications

References 42 publications

C-Reactive Protein-to-Albumin Ratio as an Early Biomarker to Identify Sepsis in Neonates with Pneumonia

C-Reactive Protein-to-Albumin Ratio as an Early Biomarker to Identify Sepsis in Neonates with Pneumonia

The Ratio of Red Blood Cell Distribution Width to Albumin as a Predictor for Rehospitalization Risk and Rehospitalization All-Cause Mortality in Middle-Aged and Elderly Survivors with Sepsis: An Ambispective ICU Cohort Study

Albumin Level is Associated with Short-Term and Long-Term Outcomes in Sepsis Patients Admitted in the ICU: A Large Public Database Retrospective Research

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