PREDICTING MORTALITY AND CLINICAL OUTCOMES IN ICU PATIENTS USING CRP/ALBUMIN AND LACTATE/ALBUMIN RATIOS: A CROSS-SECTIONAL STUDY

Abstract

Background: Early risk stratification in critically ill patients is crucial for improving outcomes, and biomarker-based approaches, such as the CRP/Albumin and Lactate/Albumin ratios, offer potential prognostic value.

Objectives: To evaluate the prognostic accuracy of lactate/albumin ratio and the CRP/albumin ratio in critically ill patients during their ICU stay in predicting mortality, need for inotropic support, mechanical ventilation and duration of ICU stay. Methods: This was a single centre, hospital based, analytical cross-sectional study conducted in the Department of Emergency Medicine and Medical ICU, Vinayaka Mission’s Medical College & Hospital, Puducherry for a duration of 18 months.

Results: This study analyzed 50 critically ill patients, with 64% aged 60 years or older and 56% being male. More than half (54%) had an ICU stay of fewer than three days, while 66% had a hospital stay of fewer than seven days. Invasive or CPAP ventilation was required in 44% of cases, and 32% of patients needed inotropic support. The overall survival rate was 82%, with 18% of patients succumbing to their illness. Non-survivors had significantly elevated CRP levels (p=0.001) and a higher CRP/albumin ratio (p=0.001), while the lactate/albumin ratio showed a trend toward significance (p=0.062). Patients requiring inotropic support exhibited significantly elevated CRP, CRP/albumin, and lactate/albumin ratios. Similarly, intubated patients had higher CRP (p=0.042) and CRP/albumin ratios (p=0.042). The CRP/albumin ratio correlated significantly with ICU stay (p=0.009) but not with total hospital stay. It also demonstrated a strong predictive value for mortality (AUC=0.843, p=0.001) and was superior to the lactate/albumin ratio in predicting inotropic support, invasive ventilation, and prolonged ICU stays.

Conclusion: The study highlights the CRP/albumin ratio as a strong prognostic marker for mortality, inotropic support, and invasive ventilation in critically ill patients. Its superior predictive value suggests its potential for early risk stratification and improved clinical decision-making.