A New Mortality Predictor in Patients of Internal Medicine Intensive Care Unit: C-Reactive Protein-to-Albumin Ratio

Abstract

Aims: C-reactive protein (CRP) and albumin can be used as prognostic markers for various clinical results, thecombination of these markers has even greater prognostic value. This study aimed to examine whether the C-reactiveprotein-to-albumin ratio (CAR) has any prognostic role in respect of mortality in intensive care unit (ICU) patients.Methods: A retrospective evaluation was made of 119 patients in the ICU in respect of demographiccharacteristics, disease diagnosis, laboratory data, CAR, and acute physiology and chronic health evaluation II(APACHE II) scores.Results: The mean APACHE II scores and the total length of stay in hospital values were significantly higher,albumin was low and the mean CRP and CAR values were high in the non-survivors group. In the multivariateanalysis, CAR, and APACHE II were determined as independent determinants. The Kaplan-Meier curve andthe Log-Rank test showed that total 60-day mortality was higher in the patient group with high CAR. In theROC curve analysis applied for 60-day mortality after admission to ICU, the area under the curve values ofAPACHE II and CAR were calculated as 0.947 and 0.676 respectively.Conclusion: Few studies are available in the literature about the CAR value in general ICU patients was evaluatedin respect of mortality. It was determined that increased CAR values were associated with mortality. This can beconsidered an important parameter as the predictive rates of mortality are as high as those of APACHE II, and itis a low-cost and readily available parameter that can be used alone in the determination of mortality prediction.