Lu Xin, Liu Wei-Chen, Qin Yan, Chen Du, Yang Peng, Chen Xiong-Hui, Wu Si-Rong, Xu Feng
Emergency Department, the First Affiliated Hospital of Soochow University, Suzhou, 215000, China.
Curr Med Sci. 2023 Apr;43(2):360-366. doi: 10.1007/s11596-023-2714-9. Epub 2023 Mar 21.
C-reactive protein (CRP)/albumin ratio (CAR) is a new inflammation-based index for predicting the prognosis of various diseases. The CAR determined on admission may help to predict the prognostic value of multiple trauma patients.
A total of 264 adult patients with severe multiple trauma were included for the present retrospective study, together with the collection of relevant clinical and laboratory data. CAR, CRP, albumin, shock index and ISS were incorporated into the prognostic model, and the receiver operating characteristic (ROC) curve was drawn. Then, the shock index for patients with different levels of CAR was analyzed. Finally, univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for the 28-day mortality of multiple trauma patients.
A total of 36 patients had poor survival outcomes, and the mortality rate reached 13.6%. Furthermore, after analyzing the shock index for patients with different levels of CAR, it was revealed that the shock index was significantly higher when CAR was ≥4, when compared to CAR <2 and 2≤ CAR <4, in multiple trauma patients. The multivariate logistic analysis helped to identify the independent association between the variables CAR (P=0.029) and shock index (P=0.019), and the 28-day mortality of multiple trauma patients.
CAR is higher in patients with severe multiple trauma. Furthermore, CAR serves as a risk factor for independently predicting the 28-day mortality of multiple trauma patients. The shock index was significantly higher when CAR was ≥4 in multiple trauma patients.
C反应蛋白（CRP）/白蛋白比值（CAR）是一种基于炎症的新型指标，用于预测各种疾病的预后。入院时测定的CAR可能有助于预测多发伤患者的预后价值。
本回顾性研究共纳入264例成年严重多发伤患者，并收集相关临床和实验室数据。将CAR、CRP、白蛋白、休克指数和损伤严重度评分（ISS）纳入预后模型，并绘制受试者工作特征（ROC）曲线。然后，分析不同CAR水平患者的休克指数。最后，进行单因素和多因素逻辑回归分析，以确定多发伤患者28天死亡率的独立危险因素。
共有36例患者生存结局不佳，死亡率达13.6%。此外，在分析不同CAR水平患者的休克指数后发现，多发伤患者中，当CAR≥4时，休克指数显著高于CAR<2和2≤CAR<4时。多因素逻辑分析有助于确定变量CAR（P=0.029）和休克指数（P=0.019）与多发伤患者28天死亡率之间的独立关联。
严重多发伤患者的CAR较高。此外，CAR是独立预测多发伤患者28天死亡率的危险因素。多发伤患者中，当CAR≥4时，休克指数显著更高。
