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C-Reactive Protein-to-Albumin Ratio in Predicting Mortality in Patients With Ileus: A Comparative Analytical Study
Serdar Özdemir1, İbrahim Altunok1
1Department of Emergency Medicine, Umraniye Training and Research Hospital, Istanbul, Turkey.
Introduction:
To evaluate the predictability of in-hospital mortality in patients followed up in the emergency department with a diagnosis of ileus using the C-reactive protein (CRP)-to-albumin ratio (CAR) and the Glasgow Prognostic Score (GPS) and to compare the diagnostic performance of these two biomarkers.
Methods:
The study included 270 patients aged ≥18 y, diagnosed with ileus in the emergency department of a university hospital between January 2022 and December 2024, for whom complete laboratory data were available. CAR was calculated by dividing CRP by albumin, while GPS was scored based on CRP >10 mg/L and albumin <35 g/L values. Factors associated with mortality were evaluated using univariate and multivariate logistic regression analyses, and diagnostic accuracy was determined using the area under the receiver operating characteristic curve.
Results:
Among the patients, 7.4% had in-hospital mortality. CAR and GPS values were found to be significantly higher in the mortality group. In receiver operating characteristic analysis, the area under the receiver operating characteristic curve value of CAR was calculated as 0.729, while that of GPS was 0.676, indicating a higher discriminatory power for CAR. In multivariate logistic regression analyses, CAR demonstrated a statistically significant and independent association with mortality (odds ratio = 0.859; 95% confidence interval: 0.747-0.988; P = 0.033). GPS was also identified as an independent predictor (odds ratio = 0.393; 95% confidence interval: 0.174-0.892; P = 0.025).
Conclusions:
CAR and GPS are valuable markers for predicting mortality risk in patients with ileus. However, CAR showed slightly better discriminative performance than GPS, although the difference was modest.