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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

Authors
 Min Hyung Kim  ;  Jin Young Ahn  ;  June Myung Kim  ;  Young Sam Kim  ;  Jun Young Choi  ;  Young Goo Song  ;  Sang Hoon Han  ;  Nam Su Ku  ;  Su Jin Jeong  ;  Sun Bean Kim  ;  Yong Duk Jeon  ;  Jung Ho Kim  ;  Jae Kyoung Kim  ;  Hea Won Ann  ;  Heun Choi  ;  Je Eun Song 
Citation
 PLoS One, Vol.10(7) : e0132109, 2015 
Journal Title
 PLoS One 
ISSN
 1932-6203 
Issue Date
2015
Abstract
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.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141202
DOI
10.1371/journal.pone.0132109
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
구남수(Ku, Nam Su) ; 김민형(Kim, Min Hyung) ; 김선빈(Kim, Sun Bean) ; 김영삼(Kim, Young Sam) ; 김재경(Kim, Jae Kyoung) ; 김정호(Kim, Jung Ho) ; 김준명(Kim, June Myung) ; 송영구(Song, Young Goo) ; 송제은(Song, Je Eun) ; 안진영(Ahn, Jin Young) ; 안혜원(Ann, Hea Won) ; 전용덕(Jeon, Yong Duk) ; 정수진(Jeong, Su Jin) ; 최준용(Choi, Jun Yong) ; 최흔(Choi, Heun) ; 한상훈(Han, Sang Hoon)
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