Emergency Department, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
Int J Clin Pract. 2021 Jul;75(7):e14263. doi: 10.1111/ijcp.14263. Epub 2021 May 13.
Due to the high mortality of coronavirus disease 2019 (COVID-19), there are difficulties in the managing emergency department. We investigated whether the D-dimer/albumin ratio (DAR) and fibrinogen/albumin ratio (FAR) predict mortality in the COVID-19 patients.
A total of 717 COVID-19 patients who were brought to the emergency department from March to October 2020 were included in the study. Levels of D-dimer, fibrinogen and albumin, as well as DAR, FAR, age, gender and in-hospital mortality status of the patients, were recorded. The patients were grouped by in-hospital mortality. Statistical comparison was conducted between the groups.
Of the patients included in the study, 371 (51.7%) were male, and their median age was 64 years (50-74). There was in-hospital mortality in 126 (17.6%) patients. The area under the curve (AUC) and odds ratio values obtained by DAR to predict in-hospital mortality were higher than the values obtained by the all other parameters (AUC of DAR, albumin, D-dimer, FAR and fibrinogen: 0.773, 0.766, 0.757, 0.703 and 0.637, respectively; odds ratio of DAR > 56.36, albumin < 4.015, D-dimer > 292.5, FAR > 112.33 and fibrinogen > 423:7.898, 6.216, 6.058, 4.437 and 2.794, respectively). In addition; patients with concurrent DAR > 56.36 and FAR > 112.33 had an odds ratio of 21.879 with respect to patients with concurrent DAR < 56.36 and FAR < 112.33.
DAR may be used as a new marker to predict mortality in COVID-19 patients. In addition, the concurrent high DARs and FARs were found to be more valuable in predicting in-hospital mortality than either separately.
由于 2019 年冠状病毒病（COVID-19）的死亡率很高，因此在急诊科的管理方面存在困难。我们研究了 D-二聚体/白蛋白比值（DAR）和纤维蛋白原/白蛋白比值（FAR）是否可预测 COVID-19 患者的死亡率。
本研究共纳入 2020 年 3 月至 10 月期间从急诊科就诊的 717 例 COVID-19 患者。记录了 D-二聚体、纤维蛋白原和白蛋白水平，DAR、FAR、年龄、性别和住院死亡率。根据住院死亡率将患者分组。对各组进行统计学比较。
本研究中 371 例（51.7%）为男性，中位年龄为 64 岁（50-74 岁）。126 例（17.6%）患者住院死亡。DAR 预测住院死亡率的曲线下面积（AUC）和优势比（OR）值均高于其他所有参数（DAR、白蛋白、D-二聚体、FAR 和纤维蛋白原的 AUC 值分别为 0.773、0.766、0.757、0.703 和 0.637；DAR>56.36、白蛋白<4.015、D-二聚体>292.5、FAR>112.33 和纤维蛋白原>423 的 OR 值分别为 7.898、6.216、6.058、4.437 和 2.794）。此外，同时存在 DAR>56.36 和 FAR>112.33 的患者的 OR 值为 21.879，而同时存在 DAR<56.36 和 FAR<112.33 的患者的 OR 值为 1。
DAR 可作为预测 COVID-19 患者死亡率的新标志物。此外，同时存在高 DAR 和 FAR 比单独存在更能预测住院死亡率。
