Yang XingYi, Ying Yi, Zhang Min, Lv LiHong, Wang XiaoXiao, Fang JunWei
Department of Gastroenterology Disease, XianJu People's Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People's Hospital, Affiliated Xianju's Hospital, Hangzhou Medical College, Xianju, Taizhou, Zhejiang, China.
Department of Gastroenterology Disease, The Hospital of Xian Ju, 53 Beidong Road, Xianju County, Taizhou, Zhejiang, 317300, China.
BMC Gastroenterol. 2025 Jul 10;25(1):511. doi: 10.1186/s12876-025-04103-7.
While the prognostic value of the international normalized ratio - to - albumin ratio (PTAR) has been established in several diseases, its predictive value in acute pancreatitis (AP) mortality remains uncertain. This study aimed to investigate the association between PTAR and survival outcomes in AP patients.
Initial screening using univariate and multivariate regression analysis identified significant prognostic variables. Survival distributions according to different PTAR levels were compared using the Kaplan - Meier (K - M) method. Receiver operating characteristic (ROC) curves were used to evaluate its discriminative performance in terms of sensitivity and specificity. Nonlinear relationships of PTAR with survival outcomes were assessed using restricted cubic spline (RCS) regression, and stratified cohort examinations were conducted to address potential confounding effects.
A total of 459 patients were enrolled in this study. They were categorized into two groups based on their PTAR scores: high - risk (≥ 0.58) and low - risk (< 0.58). A significant association was found between elevated PTAR and increased mortality at various time points, such as 7, 14, 21, 28, 90, and 365 days (P < 0.05). The Cox proportional hazards model revealed a significant independent association between higher PTAR and mortality, with hazard ratios consistently significant across all time points (P < 0.05). Patients in the high - risk group showed persistently higher mortality rates (P < 0.05 for all comparative time points). ROC analysis showed similar predictive performance of PTAR and the SOFA score for mortality. No statistically significant interaction between PTAR status and treatment effects was observed (p > 0.05).
PTAR has shown significant associations with clinical outcomes in patients with AP.
虽然国际标准化比值与白蛋白比值（PTAR）的预后价值已在多种疾病中得到证实，但其对急性胰腺炎（AP）死亡率的预测价值仍不确定。本研究旨在探讨PTAR与AP患者生存结局之间的关联。
通过单因素和多因素回归分析进行初步筛选，确定显著的预后变量。使用Kaplan-Meier（K-M）方法比较不同PTAR水平的生存分布。采用受试者工作特征（ROC）曲线评估其在敏感性和特异性方面的判别性能。使用受限立方样条（RCS）回归评估PTAR与生存结局的非线性关系，并进行分层队列研究以解决潜在的混杂效应。
本研究共纳入459例患者。根据PTAR评分将他们分为两组：高危（≥0.58）和低危（<0.58）。在7、14、21、28、90和365天等不同时间点，发现PTAR升高与死亡率增加之间存在显著关联（P<0.05）。Cox比例风险模型显示，较高的PTAR与死亡率之间存在显著的独立关联，在所有时间点风险比值均显著（P<0.05）。高危组患者的死亡率持续较高（所有比较时间点P<0.05）。ROC分析显示，PTAR和序贯器官衰竭评估（SOFA）评分对死亡率的预测性能相似。未观察到PTAR状态与治疗效果之间存在统计学显著的相互作用（p>0.05）。
PTAR与AP患者的临床结局显著相关。
