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| Study on the value of ratio of C- reactive protein to prealbumin levels in prognosis of sepsis |
| Zhang Li-Li, Yu Xue-Zhong, Yu Shan-Shan, Zhao Jiao |
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Abstract Objective Dynamic monitoring the levels of serum C-reactive protein（CRP）, prealbumin（PA）, calculate the ratio of CRP to PA to assess the value of which in prognosis of sepsis. Methods 137 cases of patients with sepsis, admitted in ICU of the Second People's Hospital of Guiyang from January, 2016 to August, 2016, were divided into the survival group with 97 cases and the death group with 40 cases. Plasmas of all patients on the day of confirmation and 72 h after treatment were collected and followed to test CRP and PA, as well as to calculate CRP/PA. Corresponding clinical data such as breathing rate, heart rate, blood pressure, numeration of leukocyte and other indicators were recorded.Acute physiology and chronic health evaluation-Ⅱ（APACHEⅡ）scoring system were evaluated, and serum samples were collected to test procalcitonin（PCT）. The above indexes between two groups were analyzed and compared. ROC curve was applied to assess the capacity of each index to predict the death rate of patients with sepsis. Results In comparison of the same case on the day of confirmation, serum CRP/PA, PCT and APACHEⅡ score of the death group was higher than those of the survival group（P＜0.05）, but CRP in tow groups was compared, the difference was not statistically significant（P＞0.05）.In comparison of indexes of the death group on the day of confirmation and 72 h after treatment, serum CRP/PA, PCT level and APACHEⅡscore on 72 h after treatment were higher than those on the day of confirmation（P＜0.05）. ROC curve was applied to assess the capacity of each index to predict the death
rate of patients with sepsis; area under ROC curve of CRP/PA was the largest（0.766）, which was of highest value in predicting death caused by sepsis. When took 2.4 as the critical value of CRP/PA, it had best sensitivity and specificity of 77.5% and 72.2% respectively, and the accuracy to predict death caused by sepsis was 73.7%. Conclusion CRP/PA could assess the prognosis of patients at the early stage; dynamically monitor CRP/PA of patients with sepsis, continuous rise of its level reveals bad prognosis.
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Received: 16 January 2017
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