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PREDICTIVE VALUE OF THE CRP/ALBUMIN RATIO FOR 28-DAY OUTCOMES IN PATIENTS WITH SEVERE COMMUNITY-ACQUIRED PNEUMONIA
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Abstract
Background: Severe community-acquired pneumonia represents a global healthcare challenge with mortality rates reaching up to 25% in intensive care units despite advances in diagnostic and therapeutic modalities. Early prognostic assessment of patient outcomes therefore plays a pivotal role in the management and monitoring process. In this context, the CRP-to-albumin ratio is increasingly utilized in contemporary research as a prognostic indicator of disease severity or mortality prediction across diverse patient populations. C-reactive protein and albumin are readily available biochemical parameters that can be obtained at all levels of healthcare delivery and immediately upon diagnosis of severe community-acquired pneumonia. The objective of this study was to determine the prognostic value of the CRP-to-albumin ratio in predicting 28-day outcomes in patients with severe community-acquired pneumonia. Methods: A prospective cohort study was conducted on 105 patients with severe community-acquired pneumonia treated at Gia Dinh People's Hospital from October 2024 to June 2025. Results: Non-survivors had significantly higher median serum C-reactive protein levels compared to survivors (190.8 vs 103.01 mg/L, p<0.001) and significantly lower mean serum albumin levels (25.3 vs 29.71 g/L, p =0.014). The median CRP-to-albumin ratio was 4. There was a significant difference in the CRP-to-albumin ratio between survivors (3.7) and non-survivors (8.0) (p<0.001). Receiver operating characteristic (ROC) curve analysis demonstrated that the CRP-to-albumin ratio had good predictive performance for 28-day mortality with an area under the curve (AUC) of 0.817 (95% CI: 0.727-0.907; p< 0.001). Using a cut-off value of 5.23, the sensitivity and specificity were 84.2% and 73.3%, respectively. Conclusion: Serum CRP/Albumin ratio was significantly higher in non-survivors compared to survivors and demonstrated good predictive value for 28-day mortality in patients with severe community-acquired pneumonia.
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Keywords
severe community-acquired pneumonia, serum CRP/Albumin ratio.
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