Assessing the Prognostic Value of Crp/Albumin Ratio and Lactate/Albumin Ratio in Critically Ill Patients.

UNLABELLED

The ability to predict the fate of critically ill patients admitted to an intensive care unit is very important, as there are only few studies which have focused on this aspect. Our study has focused to determine the relationship between C-Reactive protein/Albumin ratio (CAR) and Lactate/Albumin ratio (LAR) and Intensive care unit stay, the requirement for vasopressor and mechanical ventilator support, recovery and mortality in the patients admitted to critical care unit.

MATERIAL

The study group comprised of 100 patients who were admitted to critical care unit. These patients were evaluated using a structured proforma, detailed case history and clinical examination. Blood sample collection was done after obtaining valid consent from the subjects immediately after admission and serum Albumin, Lactate and C- reactive protein levels were estimated in these patients.

OBSERVATION

The mean age of the patients in our study was 54.05.Out of the total patients admitted 74% of the patients were males. The common diagnosis was COVID bronchopneumonia (12%). 75% cases were seen having Glasgow Coma scale 15. 88% cases required FIO2 less than 50%. Based on Youden's index, LAR of 0.84 is the ideal cut off with 76.9% sensitivity and 83.8% specificity. Similarly for CAR, the ideal cut off is 88.2 with 84.6% sensitivity and 98.6% specificity. LAR and CAR values greater than 0.84 and 88.2 respectively were considered to be higher values. The patients with high LAR and high CAR values either had increased risk of mortality or increased duration of stay in the hospital (p=0.0001). Patients with low Albumin level and high CRP required Ventilator support which was statistically significant. Patients who needed inotropic support and mechanical ventilator support had higher CAR (P=0.001). Patients who received inotrope support had higher ESR and CRP levels.

CONCLUSION

CAR and LAR are better indicators of mortality and duration of stay in the intensive care unit as the patients with higher values of these ratios were found to have increased risk of mortality. However CAR was found to be a better indicator of mortality than LAR and it was also noted that the patients who required inotropes and mechanical ventilator support were found to have higher CAR.