Albumin-to-Fibrinogen Ratio Independently Predicts 28-Day Mortality in Patients with Peritonitis-Induced Sepsis

Overview

Journal Mediators Inflamm

Publisher Wiley

Specialties Biochemistry
Pathology

Date 2020 May 27

PMID 32454793

Citations 13

Authors

Huiyu Tai

Zhiyun Zhu

Haifeng Mei

Wenbin Sun

Wei Zhang

Affiliations

Soon will be listed here.

Abstract

Background: This study is aimed at investigating whether albumin-to-fibrinogen ratio (AFR) could independently predict the prognosis in patients with peritonitis-induced sepsis.

Methods: A total of 246 eligible patients who were scheduled to undergo surgical treatment for peritonitis-induced sepsis were enrolled in this study. The primary observational endpoint was 28-day hospital mortality. Cox proportional hazards regression analysis with the Wald test was performed to identify prognostic factors for 28-day mortality in septic patients. Receiver operating characteristic (ROC) and Kaplan-Meier curve analyses were carried out to evaluate the association of baseline AFR and prognosis in septic patients.

Results: Of all the cohort study participants, there were 59 nonsurvivors with a 28-day mortality of 24.0% (59/246). Baseline AFR (hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.42-0.93, = 0.018) and the presence of septic shock (HR: 2.43, 95% CI: 1.42-3.91, = 0.021) were two independent prognostic factors for 28-day mortality in patients with peritonitis-induced sepsis by multivariate Cox analysis. Baseline AFR was a significant predictor for 28-day mortality with an area under the curve (AUC) of 0.751, a cut-off value of 8.85, a sensitivity of 66.10%, and a specificity of 70.05%, respectively (95% CI: 0.688-0.813, < 0.001). A low baseline AFR level (≤8.85) was significantly associated with a lower overall survival rate in septic patients by Kaplan-Meier curve analysis with log-rank test ( = 0.004).

Conclusions: This study indicates that AFR independently predicts 28-day mortality in patients with peritonitis-induced sepsis.

Citing Articles

The relationship between potassium levels and 28-day mortality in sepsis patients: Secondary data analysis using the MIMIC-IV database.

Tang J, Zhao P, Li Y, Liu S, Chen L, Chen Y Heliyon. 2024; 10(11):e31753.

PMID: 38845906 PMC: 11154597. DOI: 10.1016/j.heliyon.2024.e31753.

The Ratio of Red Blood Cell Distribution Width to Albumin as a Predictor for Rehospitalization Risk and Rehospitalization All-Cause Mortality in Middle-Aged and Elderly Survivors with Sepsis: An Ambispective ICU Cohort Study.

Tan Y, Li Y, Huang X, Zhai Z, Wang Q, Guo Y J Inflamm Res. 2024; 17:1227-1240.

PMID: 38410420 PMC: 10896106. DOI: 10.2147/JIR.S451769.

Prognostic value of albumin to fibrinogen ratio for mortality in patients with hypertrophic cardiomyopathy.

Li L, Ban C, Ruan H, Zhang M, Wang Z, Ma M BMC Cardiovasc Disord. 2023; 23(1):559.

PMID: 37974066 PMC: 10652625. DOI: 10.1186/s12872-023-03562-8.

Association between ferritin to albumin ratio and 28-day mortality in patients with sepsis: a retrospective cohort study.

Liu F, Liu Z Eur J Med Res. 2023; 28(1):414.

PMID: 37817258 PMC: 10563292. DOI: 10.1186/s40001-023-01405-y.

Low albumin-to-fibrinogen ratio predicts adverse clinical outcomes after primary total joint arthroplasty: A retrospective observational investigation.

Shang J, Jiang S, Gong J, Zhao G, Su D, Wang L Int Wound J. 2023; 20(9):3690-3698.

PMID: 37257885 PMC: 10588346. DOI: 10.1111/iwj.14260.

References

Huttunen R, Aittoniemi J . New concepts in the pathogenesis, diagnosis and treatment of bacteremia and sepsis. J Infect. 2011; 63(6):407-19. DOI: 10.1016/j.jinf.2011.08.004. View

Kim J, Park J, Kim D, Choi W, Cheong J, Kim J . The delta neutrophil index is a prognostic factor for postoperative mortality in patients with sepsis caused by peritonitis. PLoS One. 2017; 12(8):e0182325. PMC: 5538749. DOI: 10.1371/journal.pone.0182325. View

Newnham E, Harwood K, Page A . Evaluating the clinical significance of responses by psychiatric inpatients to the mental health subscales of the SF-36. J Affect Disord. 2006; 98(1-2):91-7. DOI: 10.1016/j.jad.2006.07.001. View

Hotchkiss R, Karl I . The pathophysiology and treatment of sepsis. N Engl J Med. 2003; 348(2):138-50. DOI: 10.1056/NEJMra021333. View

Charlson M, Charlson R, Peterson J, Marinopoulos S, Briggs W, Hollenberg J . The Charlson comorbidity index is adapted to predict costs of chronic disease in primary care patients. J Clin Epidemiol. 2008; 61(12):1234-1240. DOI: 10.1016/j.jclinepi.2008.01.006. View

Suetrong B, Walley K . Lactic Acidosis in Sepsis: It's Not All Anaerobic: Implications for Diagnosis and Management. Chest. 2015; 149(1):252-61. DOI: 10.1378/chest.15-1703. View

Ying J, Zhou D, Gu T, Huang J, Liu H . Pretreatment albumin/fibrinogen ratio as a promising predictor for the survival of advanced non small-cell lung cancer patients undergoing first-line platinum-based chemotherapy. BMC Cancer. 2019; 19(1):288. PMC: 6441182. DOI: 10.1186/s12885-019-5490-y. View

Casserly B, Phillips G, Schorr C, Dellinger R, Townsend S, Osborn T . Lactate measurements in sepsis-induced tissue hypoperfusion: results from the Surviving Sepsis Campaign database. Crit Care Med. 2014; 43(3):567-73. DOI: 10.1097/CCM.0000000000000742. View

Arnau-Barres I, Guerri-Fernandez R, Luque S, Sorli L, Vazquez O, Miralles R . Serum albumin is a strong predictor of sepsis outcome in elderly patients. Eur J Clin Microbiol Infect Dis. 2019; 38(4):743-746. DOI: 10.1007/s10096-019-03478-2. View

10.

Li S, Jiang Y, Lin J, Zhang J, Sun F, Gao Q . Albumin-to-fibrinogen ratio as a promising biomarker to predict clinical outcome of non-small cell lung cancer individuals. Cancer Med. 2018; 7(4):1221-1231. PMC: 5911606. DOI: 10.1002/cam4.1428. View

11.

Signoff J, Fitzgerald J, Teachey D, Balamuth F, Weiss S . Hypofibrinogenemia Is Associated With Poor Outcome and Secondary Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome in Pediatric Severe Sepsis. Pediatr Crit Care Med. 2018; 19(5):397-405. PMC: 9630256. DOI: 10.1097/PCC.0000000000001507. View

12.

Levy M, Fink M, Marshall J, Abraham E, Angus D, Cook D . 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Intensive Care Med. 2003; 29(4):530-8. DOI: 10.1007/s00134-003-1662-x. View

13.

Yu W, Ye Z, Fang X, Jiang X, Jiang Y . Preoperative albumin-to-fibrinogen ratio predicts chemotherapy resistance and prognosis in patients with advanced epithelial ovarian cancer. J Ovarian Res. 2019; 12(1):88. PMC: 6751810. DOI: 10.1186/s13048-019-0563-8. View

14.

Dellinger R, Levy M, Rhodes A, Annane D, Gerlach H, Opal S . Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013; 39(2):165-228. PMC: 7095153. DOI: 10.1007/s00134-012-2769-8. View

15.

Vincent J, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter P . Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. Crit Care Med. 1998; 26(11):1793-800. DOI: 10.1097/00003246-199811000-00016. View

16.

Manu V, Chakrabarty B, Singh S . Analysis of platelet-activating factors in severe sepsis by flow cytometry and its correlation with clinical sepsis scoring system: A pilot study. Med J Armed Forces India. 2019; 75(4):429-436. PMC: 6838495. DOI: 10.1016/j.mjafi.2018.06.012. View

17.

Moreno R, Metnitz P, Almeida E, Jordan B, Bauer P, Abizanda Campos R . SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission. Intensive Care Med. 2005; 31(10):1345-55. PMC: 1315315. DOI: 10.1007/s00134-005-2763-5. View

18.

Jahn M, Rekowski J, Gerken G, Kribben A, Canbay A, Katsounas A . The predictive performance of SAPS 2 and SAPS 3 in an intermediate care unit for internal medicine at a German university transplant center; A retrospective analysis. PLoS One. 2019; 14(9):e0222164. PMC: 6760764. DOI: 10.1371/journal.pone.0222164. View

19.

Tokunaga R, Sakamoto Y, Nakagawa S, Miyamoto Y, Yoshida N, Oki E . Prognostic Nutritional Index Predicts Severe Complications, Recurrence, and Poor Prognosis in Patients With Colorectal Cancer Undergoing Primary Tumor Resection. Dis Colon Rectum. 2015; 58(11):1048-57. DOI: 10.1097/DCR.0000000000000458. View

20.

Martin G, Mannino D, Eaton S, Moss M . The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003; 348(16):1546-54. DOI: 10.1056/NEJMoa022139. View