Difference in hematocrit and plasma albumin levels as an additional biomarker in the diagnosis of infectious disease

Abstract

Introduction: In clinical practice, it has been observed that patients with severe infections show changes to their hematocrit (HCT) and serum albumin (ALB) levels. This study aimed to evaluate whether the difference of HCT and ALB (HCT-ALB) levels can be used as an additional biomarker for fast diagnosis of severe infections. Material and methods: This was a retrospective case-control study which included adult patients with severe infections, patients with non-infective conditions and healthy individuals. A total of 7,117 individuals were recruited in Yunnan Province, China, from January 2012 to January 2018, and were divided into three groups: 1,033 patients with severe infections (group 1); 1,081 patients with non-infective conditions (group 2); and 5,003 healthy individuals from the general population (group 3). The potential diagnostic threshold of HCT-ALB for severe infectious patients was determined by the receiver operating characteristic (ROC) curve analysis. Group 3 was used as the reference to draw the ROC curves of the HCT-ALB value in group 1 or group 2. Results: HCT-ALB values in each group were significantly different. We found that the area under the ROC curve (AUC) of group 1 reached 0.87 (95% CI: 0.86-0.89), whereas the AUC of group 2 was 0.60 (95% CI: 0.58-0.62). To reach a higher specificity of 99.0% (95% CI: 98.8-99.3%, and with sensitivity of 37.5%, 95% CI: 34.5-40.5%), a HCT-ALB value of 10.25 was recommended as the standard for diagnosis of severe infection. Conclusions: The HCT-ALB value was increased in patients with infectious disease. The measurement of the HCT-ALB value (> 10.25) might be useful in the fast diagnosis of infectious disease.

Association between hematocrit-to-albumin ratio and acute kidney injury in patients with acute pancreatitis: a retrospective cohort study

“…The HCT-ALB level above 6.8 proves useful in distinguishing these conditions 16 . Additionally, they also observed that HCT-ALB level above 10.25 might facilitate the rapid diagnosis of severe infections 34 . Wang et al con rmed the importance of HCT-ALB levels in predicting the outcomes of elderly sepsis patients, using data from the MIMIC-IV and eICU-CRD databases 18 .…”

The Pharmacokinetics of Gefitinib in a Chinese Cancer Population Group: A Virtual Clinical Trials Population Study

“…The coloured bars represent mean and standard deviations obtained from literature studies. [30][31][32][33][34][35][36][37][38][39] For albumin and AAG, a second population was simulated with a 50% reduction in% CV.…”

“…Blue shaded regions represent a 90% confidence interval from 2000 virtual individuals simulated (black circles) using Simcyp and the solid black line represents the mean values. The coloured bars represent mean and standard deviations obtained from literature studies [30][31][32][33][34][35][36][37][38][39]. For albumin and AAG, a second population was simulated with a 50% reduction in% CV.…”

The relationship between hematocrit and serum albumin levels difference and mortality in elderly sepsis patients in intensive care units—a retrospective study based on two large database

“…In addition to the above effects of infection, the patient’s hypermetabolic state causes increased albumin consumption, intestinal dysfunction causes increased albumin loss, and patients with chronic hypoxic diseases can cause an increase in HCT, as well as blood loss and anemia, which are all factors that cause changes in HCT-ALB. The numerical difference value between HCT (%) and ALB (g/L) levels (HCT-ALB) is highly sensitive and specific among patients with infectious diseases and is, therefore, a potential indicator for the differential diagnosis of infections [ 19 ]. The relationship between HCT-ALB and the prognosis of elderly sepsis patients remains unclear.…”