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Predicting Pulmonary Exacerbations in Cystic Fibrosis Using Inflammation-Based Scoring Systems
Raphael S Reitmeier1, Melanie Götschke1, Julia Walter1,2
1Department of Medicine V, LMU University Hospital, LMU Munich, 81377 Munich, Germany.
Diagnostics (Basel, Switzerland)
|November 13, 2025
Summary
The CRP/albumin ratio effectively predicts pulmonary exacerbations (PEx) in people with cystic fibrosis (pwCF). This simple marker identifies individuals at higher risk, aiding clinical practice and PEx prevention strategies.
Area of Science:
- Pulmonology
- Clinical Medicine
- Biomarkers
Background:
- Pulmonary exacerbations (PEx) significantly impact outcomes for people with cystic fibrosis (pwCF).
- Predicting PEx is crucial for effective management and prevention strategies.
- Current definitions of PEx lack universal consensus, complicating risk assessment.
Purpose of the Study:
- To identify individuals with cystic fibrosis (pwCF) at risk for future pulmonary exacerbations (PEx).
- To evaluate established and novel markers of chronic inflammation for PEx prediction.
- To compare the efficacy of various inflammatory markers and scoring systems in predicting PEx.
Main Methods:
- Retrospective analysis of 131 adults with cystic fibrosis (CF) over a 3-year period.
- PEx defined as the need for intravenous antibiotic treatment.
- Comparison of inflammatory markers including CRP/albumin ratio, neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR), alongside Glasgow Prognostic Scores (GPS).
Main Results:
- 57.3% of pwCF experienced PEx during the follow-up period.
- Multivariate analysis identified CRP(log), CRP/albumin ratio, decreased LMR, increased NLR, and GPS as significant predictors of PEx.
- The CRP/albumin ratio demonstrated the highest predictive performance for PEx in pwCF.
Conclusions:
- Inflammation-based scoring systems can predict PEx in pwCF.
- The easily calculated CRP/albumin ratio reliably identifies pwCF at increased risk for PEx.
- The CRP/albumin ratio is a promising tool for clinical application in managing PEx risk.
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