The C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Patients with Severe Sepsis or Septic Shock Treated with Early Goal-Directed Therapy

被引:162
作者
Kim, Min Hyung [1 ]
Ahn, Jin Young [2 ,3 ]
Song, Je Eun [2 ,3 ]
Choi, Heun [2 ,3 ]
Ann, Hea Won [2 ,3 ]
Kim, Jae Kyoung [2 ,3 ]
Kim, Jung Ho [2 ,3 ]
Jeon, Yong Duk [2 ,3 ]
Kim, Sun Bean [2 ,3 ]
Jeong, Su Jin [2 ,3 ]
Ku, Nam Su [2 ,3 ]
Han, Sang Hoon [2 ,3 ]
Song, Young Goo [2 ,3 ]
Choi, Jun Young [2 ,3 ]
Kim, Young Sam [2 ]
Kim, June Myung [2 ,3 ]
机构
[1] Bundang Jesaeng Hosp, Seongam, Gyeonggi, South Korea
[2] Yonsei Univ, Dept Internal Med, Coll Med, Seoul 120749, South Korea
[3] Yonsei Univ, AIDS Res Inst, Coll Med, Seoul 120749, South Korea
关键词
SURVIVING SEPSIS; INTENSIVE-CARE; BLOOD LACTATE; PROTEIN; MARKER; INFECTION; DISCHARGE; CAMPAIGN;
D O I
10.1371/journal.pone.0132109
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Sepsis, including severe sepsis and septic shock, is a major cause of morbidity and mortality. Albumin and C-reactive protein (CRP) are considered as good diagnostic markers for sepsis. Thus, initial CRP and albumin levels were combined to ascertain their value as an independent predictor of 180-day mortality in patients with severe sepsis and septic shock. Materials and Methods We conducted a retrospective cohort study involving 670 patients (>18 years old) who were admitted to the emergency department and who had received a standardized resuscitation algorithm (early goal-directed therapy) for severe sepsis and septic shock, from November 2007 to February 2013, at a tertiary hospital in Seoul, Korea. The outcome measured was 180-day all-cause mortality. A multivariate Cox proportional hazard model was used to identify the independent risk factors for mortality. A receiver operating characteristic (ROC) curve analysis was conducted to compare the predictive accuracy of the CRP/albumin ratio at admission. Results The 180-day mortality was 28.35% (190/670). Based on the multivariate Cox proportional hazard analysis, age, the CRP/albumin ratio at admission (adjusted HR 1.06, 95% CI 1.031-10, p<0.001), lactate level at admission (adjusted HR 1.10, 95% CI 1.05-1.14, p<0.001), and the Sequential Organ Failure Assessment (SOFA) score at admission (adjusted HR 1.12, 95% CI 1.07-1.18, p<0.001) were independent predictors of 180-day mortality. The area under the curve of CRP alone and the CRP/albumin ratio at admission for 180-day mortality were 0.5620 ( P<0.001) and 0.6211 (P<0.001), respectively. Conclusion The CRP/albumin ratio was an independent predictor of mortality in patients with severe sepsis or septic shock.
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页数:13
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