Kim Keun-Soo, Oh Ah-Ran, Park Jungchan, Ryu Jeong-Am
Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
J Clin Med. 2023 Feb 10;12(4):1407. doi: 10.3390/jcm12041407.
The objective of this study was to investigate the usefulness of fibrinogen-to-albumin ratio (FAR) as a prognostic marker in patients admitted to an intensive care unit (ICU) compared with Sequential Organ Failure Assessment (SOFA) score, a widely used prognostic scoring system. An inverse probability weighting (IPW) was used to control for selection bias and confounding factors. After IPW adjustment, the high FAR group showed significantly higher risk of 1-year compared with low FAR group (36.4% vs. 12.4%, adjust hazard ratio = 1.72; 95% confidence interval (CI): 1.59-1.86; < 0.001). In the receiver-operating characteristic curve analysis associated with the prediction of 1-year mortality, there was no significant difference between the area under the curve of FAR on ICU admission (C-statistic: 0.684, 95% CI: 0.673-0.694) and that of SOFA score on ICU admission (C-statistic: 0.679, 95% CI: 0.669-0.688) ( = 0.532). In this study, FAR and SOFA score at ICU admission were associated with 1-year mortality in patients admitted to an ICU. Especially, FAR was easier to obtain in critically ill patients than SOFA score. Therefore, FAR is feasible and might help predict long-term mortality in these patients.
本研究的目的是调查与广泛使用的预后评分系统序贯器官衰竭评估(SOFA)评分相比,纤维蛋白原与白蛋白比值(FAR)作为重症监护病房(ICU)患者预后标志物的有用性。采用逆概率加权法(IPW)来控制选择偏倚和混杂因素。经过IPW调整后,高FAR组显示1年风险显著高于低FAR组(36.4%对12.4%,调整后风险比=1.72;95%置信区间(CI):1.59 - 1.86;<0.001)。在与预测1年死亡率相关的受试者工作特征曲线分析中,ICU入院时FAR的曲线下面积(C统计量:0.684,95%CI:0.673 - 0.694)与ICU入院时SOFA评分的曲线下面积(C统计量:0.679,95%CI:0.669 - 0.688)之间无显著差异(=0.532)。在本研究中,ICU入院时的FAR和SOFA评分与ICU患者的1年死亡率相关。特别是,在危重症患者中,FAR比SOFA评分更容易获得。因此,FAR是可行的,可能有助于预测这些患者的长期死亡率。