THE RATIO OF C-REACTIVE PROTEIN AND ALBUMIN IN INTENSIVE THERAPY OF PURULENT-INFLAMMATORY DISEASES OF VARIOUS ETIOLOGIES
Abstract
Background. The C-reactive protein to serum albumin ratio may be a new reliable marker of inflammation. Aims. To determine the prognostic value of the C-Reactive Protein/Albumin Ratio (CAR) in severe acute pancreatitis, purulent inflammatory diseases, coronavirus infection (COVID-19). Material and methods. The analysis of electronic and printed medical records was carried out with a continuous sample of patients in the intensive care unit in the period from February to September 2022–2023. University Clinic, Infectious Diseases Hospital of Grodno, RB. During this period, 134 patients were included in a retrospective cohort study (men 68, women 66, average age 56.82±1.56), who are in the intensive care unit with a diagnosis of severe acute pancreatitis (n=25), purulent-inflammatory diseases of various etiologies (n=25), COVID-19 (severe pneumonia, n=84). Results. Out of 134 examined patients, 2 clinical groups of patients were identified. Group 1 (n=84, average age 50.3±1.7; men 48, women 36) consisted of patients with a favorable outcome of the course and intensive therapy of severe acute pancreatitis, COVID-19 and purulent inflammatory diseases (survivors); group 2 (n=50, average age 67.8±2.28, men 20, women 30) were patients with an unfavorable outcome of the course and intensive care (deceased). Statistical differences between groups were obtained at the end of the course of intensive care (11.9±1.14 total bed days for groups 1 and 2), CAR was 1.26±0.24 and 3.85±0.56 in groups 1 and 2, respectively (p <0.000054). Using ROC analysis and calculating the Area under ROC curve indicator, the CAR indicator in the favorable and unfavorable outcome groups upon completion of intensive care programs was 0.7301±0.054. A CAR ratio ≥2.51 was found to be a cut-off marker for predicting poor prognosis in intensive care with a sensitivity of 84.62% (95% CI 71.9–93.2%) and specificity of 63.16% (95% CI 45.9–78.1%). Conclusion. CAR can serve as an independent mortality risk factor for patients in the intensive care unit diagnosed with severe acute pancreatitis, purulent inflammatory diseases of various localization, severe form COVID-19.
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