Jang Ji Hoon, Hong SungMin, Ryu Jeong-Am
Division of Pulmonology and Critical Care, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Korea.
J Clin Med. 2022 Aug 29;11(17):5067. doi: 10.3390/jcm11175067.
We evaluated the prognostic value of C-reactive protein (CRP), albumin, CRP clearance (CRPc) and CRP/albumin ratio (CAR) in neurocritically ill patients with acute stroke. This is a retrospective, observational study. We included acute stroke patients who were hospitalized in the neurosurgical ICU from January 2013 to September 2019. The primary outcome was in-hospital mortality. A total of 307 patients were enrolled in the study. Among them, 267 (87.0%) survived until discharge from the hospital. CRP and CAR were significantly higher in non-survivors than in survivors (both p < 0.001). Serum albumin levels were significantly lower in the non-survivors than in the survivors (p < 0.001). In receiver operating characteristic curve analysis for prediction of in-hospital mortality, the area under the curve of CRP (C-statistic: 0.820) and CAR (C-statistic: 0.824) were greater than that of CRPc (C-statistic: 0.650) and albumin (C-statistic: 0.734) (all p < 0.005). However, there was no significant difference in the predictive performance between CRP and CAR (p = 0.287). In this study, CRP and CAR were more important than CRPc and albumin in predicting mortality of neurocritically ill patients with stroke. Early CRP level and CAR determination may help to predict the in-hospital mortality of these patients.
我们评估了C反应蛋白（CRP）、白蛋白、CRP清除率（CRPc）和CRP/白蛋白比值（CAR）对急性卒中神经重症患者的预后价值。这是一项回顾性观察研究。我们纳入了2013年1月至2019年9月在神经外科重症监护病房住院的急性卒中患者。主要结局是住院死亡率。共有307例患者纳入研究。其中，267例（87.0%）存活至出院。非存活者的CRP和CAR显著高于存活者（均p<0.001）。非存活者的血清白蛋白水平显著低于存活者（p<0.001）。在预测住院死亡率的受试者工作特征曲线分析中，CRP（C统计量：0.820）和CAR（C统计量：0.824）的曲线下面积大于CRPc（C统计量：0.650）和白蛋白（C统计量：0.734）（均p<0.005）。然而，CRP和CAR之间的预测性能无显著差异（p=0.287）。在本研究中，CRP和CAR在预测卒中神经重症患者死亡率方面比CRPc和白蛋白更重要。早期测定CRP水平和CAR可能有助于预测这些患者的住院死亡率。
