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

• Published in: Clinical and experimental emergency medicine Vol. 4; no. 1; pp. 19 - 24
• Main Authors: Oh, Jaehun, Kim, Soo Hyun, Park, Kyu Nam, Oh, Sang Hoon, Kim, Young Min, Kim, Han Joon, Youn, Chun Song
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Emergency Medicine 01.03.2017; 대한응급의학회
• Subjects: aged; albumins; c-reactive protein; mortality; Original; 응급의학; Aged; Albumins; C-reactive protein; Mortality
• ISSN: 2383-4625; 2383-4625
• DOI: 10.15441/ceem.16.158

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). 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. 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). 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.