CRP/Albumin Değerinin Koronavirüs-19 Hastalarının Hastanede Yatış Süresi ve Hastanede Kalış Süresi Üzerindeki Klinik Önemi: Prospektif Çalışma Çalışma
Öz
Amaç: İlk tanısı acil servis te yapılan Koronavirüs 2019 (COVID-19) hastalarda C- reaktif protein/albümin oranının (CAR) tanısal ve prognostik önemini
araştırması.
Gereç ve Yöntemler: Burada sunduğumuz çalışma, tek merkezli, ileriye dönük gözlemsel bir çalışmadır. Çalışmaya toplam 745 katılımcı (385 hasta,
360 kişi) dâhil edildi. CAR, C-reaktif protein (CRP; mg/L) değerinin albümin değerine (gr) bölünmesiyle hesaplandı. Veriler MedCalc İstatistik Yazılımı
v12.7.0.0 (Oostende, Belçika) ve Student t testi, ki kare testi ve Pearson korelasyon katsayısı kullanılarak analiz edildi. p<0.05 değeri istatistiksel olarak
anlamlı kabul edildi.
Bulgular: Toplam 355 hasta yatarak tedavi edildi ve bunların 30’u ayaktan takip edildi. Hastanede yatan hastaların ve ayaktan hastaların ortalama CAR
değerleri sırasıyla 0.34±0.89 ve 0.39±0.72 idi (%95 güven aralığı [GA]: -0.31 ila 0.40; p = 0.796). 309 hasta koğuşlarda, 46 hasta ise yoğun bakım ünitelerinde
tedavi edilirken; ortalama CAR değerleri sırasıyla 0.33±0.92 ve 0.44±0.74 idi (%95 GA: -0.17 ila 0.39; p=0.449). CAR değeri arttıkça hastanede kalış
süresi de arttı (p< 0,0001). COVID-19 teşhisi için en iyi kesme noktasında CAR’ın %82.66 özgüllük, %69.72 duyarlılık, 4.02 pozitif olasılık ve 0.37 negatif
olasılığa sahip olduğu gösterildi.
Sonuç: Çalışmadaki COVID-19 hastalarının hastanede kalış süresi, ilk acil servise başvuru anında tespit edilen CAR değerleri ile yakından ilişkiliydi.rının hastanede kalış süresi, ilk acil servise başvuru anında tespit edilen CAR değerleri ile yakından ilişkiliydi.
Anahtar Kelimeler
Coronavirus disease 2019 C reactive protein to albumin ratio first admission hospital stay Coronavirüs hastalığı 2019 C-reaktif protein/albümin oranı ilk başvuru hastanede kalış süresi
Destekleyen Kurum
yok
Kaynakça
- Saylik F, Akbulut T, Kaya S. Can C-reactive protein to albumin ratio predict in-hospital death rate due to COVID-19 in patients with hypertension? Angiology. 2021;72(10):947-952.
- Ayranci MK, Kucukceran K, Dundar ZD. NLR and CRP to albumin ratio as a predictor of in-hospital mortality in the geriatric ED patients. Am J Emerg Med. 2021;44:50-55.
- Kayabasi S, Hizli O, Cayir S. A Novel Predictor Parameter for Active Recurrent Aphthous Stomatitis: C - reactive protein to Albumin Ratio. Cureus. 2019;11(10):5965.
- Duman H, Cinier G, Bakirci EM, Duman H, Simsek Z, Hamur H et al. Relationship between c-reactive protein to albumin ratio and thrombus burden in patients with acute coronary syndrome. Clin Appl Thromb Hemost. 2019;25:1076029618824418.
- Saito H, Kono Y, Murakami Y, Shishido Y, Kuroda H, Matsunaga T et al. Prognostic significance of the preoperative ratio of c-reactive protein to albumin and neutrophil-lymphocyte ratio in gastric cancer patients. World J Surg. 2018;42(6):1819-1825.
- Guney BC, Tastan YO, Dogantekin B, Serindag Z, Yeniceri M, Cicek V et al. Predictive value of CAR for in-hospital mortality in patients with covid-19 pneumonia: a retrospective cohort study. Arch Med Res. 2021;52(5):554-560.
- Covino M, De Matteis G, Polla DAD, Santoro M, Burzo ML, Torelli E et al. Predictors of in-hospital mortality and death rısk stratıfıcatıon among covıd-19 patıents aged ≥ 80 years old. Arch Gerontol Geriatr. 2021;95:104383
- Lei C, Lin W, Deng X, Hu F, Chen F, Cai W et al. Factors associated with clinical outcomes in patients with Coronavirus Disease 2019 in Guangzhou, China. J Clin Virol. 2020;133:104661.
- Huyut MT, Huyut Z, İlkbahar F, Mertoglu C. What is the impact and efficacy of routine immunological, biochemical and hematological biomarkers as predictors of COVID-19 mortality? Int Immunopharmacol. 2022;105:108542.
- Li YJ, Yao K, Lu MX, Zhang WB, Xiao C, Tu CQ. Prognostic value of the C-reactive protein to albumin ratio: A novel inflammation-based prognostic indicator in osteosarcoma. Onco Targets Ther. 2017;2(10):5255-5261.
- Hariyanto TI, Japar KV, Kwenandar F, Damay V, Siregar JI, Lugito NPH et al. Inflammatory and hematologic markers as predictors of severe outcomes in COVID-19 infection: A systematic review and meta-analysis. Am J Emerg Med. 2021;(41):110-119.
- Viana-Llamas MC, Arroyo-Espliguero R, Silva-Obregón JA, Uribe-Heredia G, Núñez-Gil I, García-Magallón B, et al. Hypoalbuminemia on admission in COVID-19 infection: An early predictor of mortality and adverse events. A retrospective observational study. Med Clin. 2021;156(9):428–436.
- Karakoyun I, Colak A, Turken M , Altin Z, Arslan FA , Iyilikci V et al. Diagnostic utility of C-reactive protein to albumin ratio as an early warning sign in hospitalized severe COVID-19 patients. Int. Immunopharmacol.2021;91:107285.
- Jin XH, Zhou HL, Chen LL, Wang FU, Han QY, Zhang JG et al. Peripheral immunological features of COVID-19 patients in Taizhou, China: A retrospective study. Clin Immunol. 2021;222:108642.
- Zuo P, Tong T, Yan Q, Cheng L, Li Y, Song K et al. Decreased prealbumin level is associated with increased risk for mortality in elderly hospitalized patients with COVID-19. Nutrition. 2020 Oct;78:110930.
- Jutzeler CR, Bourguignon L, Weis CV, Tong B, Wong C, Rieck B et al. Comorbidities, clinical signs and symptoms, laboratory findings, imaging features, treatment strategies, and outcomes in adult and pediatric patients with COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis.2020;37:101825.
- Zhang J, Wang X, Jia X, Li J, Hu K, Chen G et al. Risk factors for disease severity, unimprovement, and mortality of COVID-19 patients in Wuhan, China. Clin Microbiol Infect. 2020;26(6):767-772.
- Costela-Ruiz VJ, Illescas-Montes R, Puerta-Puerta JM, Ruiz C, Melguizo-Rodríguez L. SARS-CoV-2 infection: The role of cytokines in COVID-19 disease. Cytokine Growth Factor Rev.2020;54:62–75.
- Bao J, Li C, Zhang K, Kang H, Chen W, Gu B. Comparative analysis of laboratory indexes of severe and non-severe patients infected with COVID-19. Clin Chim Acta. 2020;509:180-194.
- Wang X, Xu Y, Huang H, Jiang D, Zhou C, Liao H et al. An increased pretreatment C-reactive protein-to-albumin ratio predicts severe novel coronavirus-infected pneumonia. Research Square 5 (2020).
- Sun Y, Dong Y, Wang L, Xie H, Li B, Chang C et al. Characteristics and prognostic factors of disease severity in patients with COVID-19: The Beijing experience. J Autoimmun. 2020;112:102473.
- Blasco LMG, Martínez JA, Toboso RQ, Sáez PS, Y.Rodríguez Marín, Aragonés LG, et al. Albumin levels and its association with outcomes in a Serie of Covid-19 patients in Spain.. Clinical Nutrition ESPEN 2020;(40):412-690.
- Xue G, Gan X, Wu Z, Xie D, Xiong Y, Hua L et al. Novel serological biomarkers for inflammation in predicting disease severity in patients with COVID-19. Int Immunopharmacol. 2020;89:107065.
Clinical Significance of CRP/Albumin Value on Hospitalization and Length of Hospital Stay of Patients with Coronavirus-19: A Prospective Study
Öz
Objective: To investigate the diagnostic and prognostic significance of the C-reactive protein-to-albumin ratio (CAR) in coronavirus disease 2019 (COVID-
19) patients admitted for the first time to a hospital emergency department (ED).
Materials and methods: The study we report herein was a single-center, prospective observational study. A total of 745 participants (385 patients, 360
individuals) were included in the study. The CAR was calculated by dividing the C-reactive protein (CRP; mg/L) value by the albumin value (gr). The data
were analyzed using MedCalc Statistical Software v12.7.0.0 (Ostend, Belgium) and Student’s t-test, chi square test, and Pearson’s correlation coefficient. A
p-value of <0.05was considered statistically significant.
Results: A total of 355 patients were hospitalized, and 30 of them were followed as outpatients. The mean CAR values of the hospitalized patients and the
outpatients were 0.34±0.89 and 0.39±0.72 respectively (95% confidence interval [CI]: -0.31 to 0.40; p=0.796). A 309 patients were hospitalized in wards
and 46, in intensive care units; their mean CAR values were 0.33±0.92 and 0.44±0.74, respectively (95% CI: -0.17 to 0.39; p=0.449). As the CAR value increased,
the length of hospital stay also increased (p<0.0001). At the best cut-off point for COVID-19 diagnosis, CAR was shown to have 82.66% specificity,
69.72% sensitivity, 4.02 positive likelihood, and 0.37 negative likelihood.
Conclusion: The length of stay in the hospital of the COVID-19 patients in the study was closely related to their CAR values obtained at the time of their
first ED admission.s closely related to their CAR values obtained at the time of their first ED admission.
Anahtar Kelimeler
Coronavirus disease 2019 C reactive protein to albumin ratio first admission hospital stay
Kaynakça
- Saylik F, Akbulut T, Kaya S. Can C-reactive protein to albumin ratio predict in-hospital death rate due to COVID-19 in patients with hypertension? Angiology. 2021;72(10):947-952.
- Ayranci MK, Kucukceran K, Dundar ZD. NLR and CRP to albumin ratio as a predictor of in-hospital mortality in the geriatric ED patients. Am J Emerg Med. 2021;44:50-55.
- Kayabasi S, Hizli O, Cayir S. A Novel Predictor Parameter for Active Recurrent Aphthous Stomatitis: C - reactive protein to Albumin Ratio. Cureus. 2019;11(10):5965.
- Duman H, Cinier G, Bakirci EM, Duman H, Simsek Z, Hamur H et al. Relationship between c-reactive protein to albumin ratio and thrombus burden in patients with acute coronary syndrome. Clin Appl Thromb Hemost. 2019;25:1076029618824418.
- Saito H, Kono Y, Murakami Y, Shishido Y, Kuroda H, Matsunaga T et al. Prognostic significance of the preoperative ratio of c-reactive protein to albumin and neutrophil-lymphocyte ratio in gastric cancer patients. World J Surg. 2018;42(6):1819-1825.
- Guney BC, Tastan YO, Dogantekin B, Serindag Z, Yeniceri M, Cicek V et al. Predictive value of CAR for in-hospital mortality in patients with covid-19 pneumonia: a retrospective cohort study. Arch Med Res. 2021;52(5):554-560.
- Covino M, De Matteis G, Polla DAD, Santoro M, Burzo ML, Torelli E et al. Predictors of in-hospital mortality and death rısk stratıfıcatıon among covıd-19 patıents aged ≥ 80 years old. Arch Gerontol Geriatr. 2021;95:104383
- Lei C, Lin W, Deng X, Hu F, Chen F, Cai W et al. Factors associated with clinical outcomes in patients with Coronavirus Disease 2019 in Guangzhou, China. J Clin Virol. 2020;133:104661.
- Huyut MT, Huyut Z, İlkbahar F, Mertoglu C. What is the impact and efficacy of routine immunological, biochemical and hematological biomarkers as predictors of COVID-19 mortality? Int Immunopharmacol. 2022;105:108542.
- Li YJ, Yao K, Lu MX, Zhang WB, Xiao C, Tu CQ. Prognostic value of the C-reactive protein to albumin ratio: A novel inflammation-based prognostic indicator in osteosarcoma. Onco Targets Ther. 2017;2(10):5255-5261.
- Hariyanto TI, Japar KV, Kwenandar F, Damay V, Siregar JI, Lugito NPH et al. Inflammatory and hematologic markers as predictors of severe outcomes in COVID-19 infection: A systematic review and meta-analysis. Am J Emerg Med. 2021;(41):110-119.
- Viana-Llamas MC, Arroyo-Espliguero R, Silva-Obregón JA, Uribe-Heredia G, Núñez-Gil I, García-Magallón B, et al. Hypoalbuminemia on admission in COVID-19 infection: An early predictor of mortality and adverse events. A retrospective observational study. Med Clin. 2021;156(9):428–436.
- Karakoyun I, Colak A, Turken M , Altin Z, Arslan FA , Iyilikci V et al. Diagnostic utility of C-reactive protein to albumin ratio as an early warning sign in hospitalized severe COVID-19 patients. Int. Immunopharmacol.2021;91:107285.
- Jin XH, Zhou HL, Chen LL, Wang FU, Han QY, Zhang JG et al. Peripheral immunological features of COVID-19 patients in Taizhou, China: A retrospective study. Clin Immunol. 2021;222:108642.
- Zuo P, Tong T, Yan Q, Cheng L, Li Y, Song K et al. Decreased prealbumin level is associated with increased risk for mortality in elderly hospitalized patients with COVID-19. Nutrition. 2020 Oct;78:110930.
- Jutzeler CR, Bourguignon L, Weis CV, Tong B, Wong C, Rieck B et al. Comorbidities, clinical signs and symptoms, laboratory findings, imaging features, treatment strategies, and outcomes in adult and pediatric patients with COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis.2020;37:101825.
- Zhang J, Wang X, Jia X, Li J, Hu K, Chen G et al. Risk factors for disease severity, unimprovement, and mortality of COVID-19 patients in Wuhan, China. Clin Microbiol Infect. 2020;26(6):767-772.
- Costela-Ruiz VJ, Illescas-Montes R, Puerta-Puerta JM, Ruiz C, Melguizo-Rodríguez L. SARS-CoV-2 infection: The role of cytokines in COVID-19 disease. Cytokine Growth Factor Rev.2020;54:62–75.
- Bao J, Li C, Zhang K, Kang H, Chen W, Gu B. Comparative analysis of laboratory indexes of severe and non-severe patients infected with COVID-19. Clin Chim Acta. 2020;509:180-194.
- Wang X, Xu Y, Huang H, Jiang D, Zhou C, Liao H et al. An increased pretreatment C-reactive protein-to-albumin ratio predicts severe novel coronavirus-infected pneumonia. Research Square 5 (2020).
- Sun Y, Dong Y, Wang L, Xie H, Li B, Chang C et al. Characteristics and prognostic factors of disease severity in patients with COVID-19: The Beijing experience. J Autoimmun. 2020;112:102473.
- Blasco LMG, Martínez JA, Toboso RQ, Sáez PS, Y.Rodríguez Marín, Aragonés LG, et al. Albumin levels and its association with outcomes in a Serie of Covid-19 patients in Spain.. Clinical Nutrition ESPEN 2020;(40):412-690.
- Xue G, Gan X, Wu Z, Xie D, Xiong Y, Hua L et al. Novel serological biomarkers for inflammation in predicting disease severity in patients with COVID-19. Int Immunopharmacol. 2020;89:107065.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Erken Görünüm Tarihi | 10 Temmuz 2023 |
| Yayımlanma Tarihi | 12 Temmuz 2023 |
| Gönderilme Tarihi | 22 Aralık 2022 |
| Kabul Tarihi | 1 Mayıs 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 18 Sayı: 2 |
