Prognostic value of the creatinine-albumin ratio in acute pancreatitis debridement.

Zhifeng Zhao, Yeping Yu, Rongli Xie, Kaige Yang, Dan Xu, Li Li, Jiayun Lin, Lei Zheng, Chihao Zhang, Xin Xu, Ying Chen, Zhiwei Xu, Erchen Chen, Meng Luo, Jian Fei

BMC surgery 2020 Dec 09

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Increases in the levels of serum C-reactive protein (CRP) and creatinine (Cr) and decreases in those of albumin (Alb) are commonly observed in acute pancreatitis (AP). We aimed to evaluate the efficacy of the Cr/Alb and CRP/Alb ratios in the prediction of surgical treatment effect in AP patients. This study retrospectively analyzed clinical data obtained from 140 AP patients who underwent debridement from January 2008 to November 2018 in Shanghai Ruijin Hospital. The Cr/Alb and CRP/Alb ratios at admission and before surgery were assessed in the analysis of clinical statistics, prediction of prognoses, and logistic regression analysis. The admission Cr/Alb had the best predictive value of the four ratios. This value was significantly higher in patients with re-operation and those who died (P < 0.05) and was correlated with the Acute Physiology and Chronic Health Evaluation (APACHE II) score, admission CRP/Alb, preoperative Cr/Alb, and post-operative complications. The admission Cr/Alb could predict the risk of AP-related re-operation and mortality with sensitivities, specificities and areas under the curve of 86.3%, 61.7% and 0.824, and 73.4%, 81.3% and 0.794, respectively. At a cut-off value of 3.43, admission Cr/Alb values were indicative of a worse clinical state, including impaired laboratory test values, APACHE II scores, rates of post-operative complications and re-operation, and mortality (P < 0.05). In the logistic regression analysis, admission Cr/Alb values were independently related to the APACHE II score, post-operative renal failure, and mortality. Cr/Alb is a novel but promising, easy-to-measure, reproducible, non-invasive prognostic score for the prediction of the effect of debridement in AP patients.

Citation

Zhifeng Zhao, Yeping Yu, Rongli Xie, Kaige Yang, Dan Xu, Li Li, Jiayun Lin, Lei Zheng, Chihao Zhang, Xin Xu, Ying Chen, Zhiwei Xu, Erchen Chen, Meng Luo, Jian Fei. Prognostic value of the creatinine-albumin ratio in acute pancreatitis debridement. BMC surgery. 2020 Dec 09;20(1):322