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

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38 Citations (Scopus)

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.

Original languageEnglish
Article numbere0132109
JournalPloS one
Volume10
Issue number7
DOIs
Publication statusPublished - 2015 Jul 9

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septic shock
sepsis (infection)
C-reactive protein
Septic Shock
C-Reactive Protein
albumins
Albumins
Sepsis
therapeutics
Mortality
Therapeutics
Hazards
Resuscitation
Organ Dysfunction Scores
hazard characterization
Protein C
Korea
cohort studies
Proportional Hazards Models
Tertiary Care Centers

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Kim, Min Hyung ; Ahn, Jin Young ; Song, Je Eun ; Choi, Heun ; Ann, Hea Won ; Kim, Jae Kyoung ; Kim, Jung Ho ; Jeon, Yong Duk ; Kim, Sun Bean ; Jeong, Su Jin ; Ku, Nam Su ; Han, Sang Hoon ; Song, Young Goo ; Choi, Jun Young ; Kim, Young Sam ; Kim, June Myung. / 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. In: PloS one. 2015 ; Vol. 10, No. 7.
@article{974fabd25efa47a2a950c99808bbfe20,
title = "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",
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.",
author = "Kim, {Min Hyung} and Ahn, {Jin Young} and Song, {Je Eun} and Heun Choi and Ann, {Hea Won} and Kim, {Jae Kyoung} and Kim, {Jung Ho} and Jeon, {Yong Duk} and Kim, {Sun Bean} and Jeong, {Su Jin} and Ku, {Nam Su} and Han, {Sang Hoon} and Song, {Young Goo} and Choi, {Jun Young} and Kim, {Young Sam} and Kim, {June Myung}",
year = "2015",
month = "7",
day = "9",
doi = "10.1371/journal.pone.0132109",
language = "English",
volume = "10",
journal = "PLoS One",
issn = "1932-6203",
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number = "7",

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Kim, MH, Ahn, JY, Song, JE, Choi, H, Ann, HW, Kim, JK, Kim, JH, Jeon, YD, Kim, SB, Jeong, SJ, Ku, NS, Han, SH, Song, YG, Choi, JY, Kim, YS & Kim, JM 2015, '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', PloS one, vol. 10, no. 7, e0132109. https://doi.org/10.1371/journal.pone.0132109

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. / Kim, Min Hyung; Ahn, Jin Young; Song, Je Eun; Choi, Heun; Ann, Hea Won; Kim, Jae Kyoung; Kim, Jung Ho; Jeon, Yong Duk; Kim, Sun Bean; Jeong, Su Jin; Ku, Nam Su; Han, Sang Hoon; Song, Young Goo; Choi, Jun Young; Kim, Young Sam; Kim, June Myung.

In: PloS one, Vol. 10, No. 7, e0132109, 09.07.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 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

AU - Kim, Min Hyung

AU - Ahn, Jin Young

AU - Song, Je Eun

AU - Choi, Heun

AU - Ann, Hea Won

AU - Kim, Jae Kyoung

AU - Kim, Jung Ho

AU - Jeon, Yong Duk

AU - Kim, Sun Bean

AU - Jeong, Su Jin

AU - Ku, Nam Su

AU - Han, Sang Hoon

AU - Song, Young Goo

AU - Choi, Jun Young

AU - Kim, Young Sam

AU - Kim, June Myung

PY - 2015/7/9

Y1 - 2015/7/9

N2 - 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.

AB - 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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DO - 10.1371/journal.pone.0132109

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AN - SCOPUS:84941330214

VL - 10

JO - PLoS One

JF - PLoS One

SN - 1932-6203

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