Ranzani et al identified predictors of 90-day mortality for septic patients discharged from the intensive care unit (ICU). The ratio of serum C-reactive protein to albumin is more predictive than either marker alone. The authors are from Universidade de Sao Paulo, Hospital Alemao Oswaldo Cruz and Hospital Sirio-Sibanes in Sao Paulo, Brazil.
Patient selection: septic adult patient at discharge from the ICU
Parameters measured at discharge:
(1) serum C-reactive protein in mg/L
(2) serum albumin in g/L
ratio in mg per g =
= (serum CRP) / (serum albumin)
Interpretation:
• A ratio > 2 was associated with increased 90-day mortality (odds ratio 2.18).
• The mortality rate for patients with a ratio <= 2 was 15% vs 31% if > 2.
Other predictors:
(1) SOFA score: odds ratio 1.36 per unit (SOFA ranges from 0 to 24, and discharge SOFA scores > 2 associated with worse survival).
(2) age: odds ratio 1.32 per 10-year increase, which becomes significant for older adults [ROUND((age)/10)]
(3) ICU length of stay > 14 days: odds ratio 2.83
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