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Prognostic value of dynamic changes in C‑reactive protein‑albumin ratio for patients with spontaneous intracerebral
Jia Li1, Guo-Min Xie2, Yan Mao1
1Department of Neurosurgery, The Affiliated LiHuiLi Hospital of Ningbo University, Ningbo, China.
Background:
To examine the predictive value of the C‑reactive protein‑albumin ratio (CAR) measured at distinct time points.
Methods:
Multivariate logistic regression was applied to examine the links of CAR 1 (at admission), CAR 2 (7th day after admission), and ΔCAR (change between CAR 1 and CAR 2) with 3-month prognosis.
Results:
CAR 2 (AUC = 0.704, 95%CI: 0.650-0.757) yielded a statistically significantly higher predictive performance for the 3-month prognosis relative to CAR 1 (AUC = 0.624, 95%CI: 0.563-0.685) and ΔCAR (AUC = 0.624, 95%CI: 0.563-0.685) (for CAR 1 or ΔCAR vs. CAR 2, both p < 0.05). The ICH score + CAR 2 (AUC = 0.817, 95%CI: 0.764-0.869) provided significantly increased predictive efficacy versus the ICH score alone (AUC = 0.776, 95%CI: 0.717-0.835) (p = 0.018). Similarly, the predictive performance of the ICH index + CAR 2 (AUC = 0.810, 95%CI: 0.762-0.859) surpassed that of the ICH index alone (AUC = 0.772, 95%CI: 0.721-0.823) (p = 0.004).
Conclusions:
CAR measured on the 7th day of admission was markedly linked to a poor 3-month prognosis and significantly increased predictive efficacy of existing prognostic scoring systems for patients with ICH. All observed associations and predictive advantages of day-7 CAR are derived from retrospective single-center data; prospective, multicenter cohort studies with independent external datasets are mandatory to verify our findings before any clinical translational use.