Clin Exp Emerg Med.  2017 Mar;4(1):19-24. 10.15441/ceem.16.158.

High-sensitivity C-reactive protein/albumin ratio as a predictor of in-hospital mortality in older adults admitted to the emergency department

Affiliations
  • 1Department of Emergency Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. ycs1005@catholic.ac.kr

Abstract


OBJECTIVE
The objective of this study was to test the hypothesis that an elevated high-sensitivity C-reactive protein (hs-CRP)/albumin ratio at admission increases the risk of mortality in older patients admitted to the hospital via the emergency department (ED).
METHODS
We performed a retrospective analysis of patients admitted to the ED with any medical problem between May 2013 and October 2013 who were older than 65 years. The hs-CRP and albumin levels were measured at the time of admission to the ED. The primary outcome was all-cause in-hospital mortality. Multivariate logistic analysis was performed.
RESULTS
A total of 811 patients were finally included in this study. The mean age was 76±7 years, and 438 subjects (54%) were male. The in-hospital mortality rate was 9.0% (73 patients). The hs-CRP/albumin ratio was higher in nonsurvivors than in survivors (34.2±37.6 vs. 16.2±25.5, P<0.001). Multivariate logistic analysis showed that the hs-CRP/albumin ratio was associated with all-cause in-hospital mortality after adjusting for other confounding factors (odds ratio, 1.011; 95% confidence interval [CI], 1.003 to 1.020). The prognostic value of the hs-CRP/albumin ratio for predicting mortality (area under the curve, 0.728; 95% CI, 0.696 to 0.758) was greater than that of hs-CRP alone (area under the curve, 0.706; 95% CI, 0.674 to 0.738; P<0.001).
CONCLUSION
The hs-CRP/albumin ratio at admission to the ED is associated with all-cause in-hospital mortality among patients older than 65 years. The hs-CRP/albumin ratio may serve as a surrogate marker of disease severity.

Keyword

Mortality; Aged; C-reactive protein; Albumins

MeSH Terms

Adult*
Albumins
Biomarkers
C-Reactive Protein
Emergencies*
Emergency Service, Hospital*
Hospital Mortality*
Humans
Male
Mortality
Retrospective Studies
Survivors
Albumins
Biomarkers
C-Reactive Protein
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