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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

 Min Hyung Kim  ;  Jin Young Ahn  ;  Je Eun Song  ;  Heun Choi  ;  Hea Won Ann  ;  Jae Kyoung Kim  ;  Jung Ho Kim  ;  Yong Duk Jeon  ;  Sun Bean Kim  ;  Su Jin Jeong  ;  Nam Su Ku  ;  Sang Hoon Han  ;  Young Goo Song  ;  Jun Young Choi  ;  Young Sam Kim  ;  June Myung Kim 
 PLOS ONE, Vol.10(7) : e0132109, 2015 
Journal Title
Issue Date
Adult ; Aged ; Area Under Curve ; C-Reactive Protein/analysis* ; Cohort Studies ; Emergency Service, Hospital ; Female ; Humans ; Kaplan-Meier Estimate ; Lactic Acid/analysis ; Male ; Middle Aged ; Proportional Hazards Models ; ROC Curve ; Resuscitation ; Retrospective Studies ; Risk Factors ; Serum Albumin/analysis ; Shock, Septic/mortality ; Shock, Septic/therapy*
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 1.03-1.10, 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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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Min Hyung(김민형)
Kim, Sun Bean(김선빈)
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Jae Kyoung(김재경)
Kim, Jung Ho(김정호) ORCID logo https://orcid.org/0000-0002-5033-3482
Kim, June Myung(김준명)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Song, Je Eun(송제은)
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
Ann, Hea Won(안혜원)
Jeon, Yong Duk(전용덕)
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Choi, Heun(최흔) ORCID logo https://orcid.org/0000-0002-9622-9381
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
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