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CRP/Albumin Ratio and NLR in Recognizing Critically Ill Patients

Year 2024, Volume: 6 Issue: 1, 38 - 41, 02.05.2024
https://doi.org/10.55994/ejcc.1435162

Abstract

Managing critically ill patients in the emergency department requires a comprehensive approach that encompasses rapid recognition, timely intervention, and continuous monitoring. These patients present with a spectrum of conditions ranging from trauma to septic shock, necessitating immediate medical attention to prevent further deterioration. The initial assessment follows the ABCDE approach, focusing on Airway, Breathing, Circulation, Disability, and Exposure. Resuscitation and stabilization efforts aim to restore perfusion and oxygenation to vital organs through fluid resuscitation, vasopressor therapy, and mechanical ventilation. Ongoing care involves vigilant monitoring of vital signs, laboratory parameters, and organ function, guiding therapeutic interventions, and informing decisions regarding escalation or de-escalation of care. Laboratory parameters, including inflammatory markers like C-reactive protein and neutrophil-to-lymphocyte ratio, play a crucial role in assessing the patient's condition, monitoring response to treatment, and predicting clinical outcomes. Multidisciplinary collaboration ensures comprehensive care tailored to the patient's needs, ultimately optimizing outcomes and reducing mortality in this high-risk population.

References

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  • 2. Özkan A. Comparison of the c-reactive protein-mean arterial pressure ratio with critical care prognostic scoring systems. Ann Clin Anal Med 2022;13(11):1257-61.
  • 3. Tuttle E, Wisecup C, Lemieux E, Wang X, Modrykamien A. Critically ill patients boarding in the emergency department and the association with intensive care unit length of stay and hospital mortality during the COVID-19 pandemic. Proc (Bayl Univ Med Cent). 2022 Jan 11;35(2):145-8.
  • 4. Thim T, Krarup NH, Grove EL, Rohde CV, Løfgren B. Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. Int J Gen Med. 2012;5:117-21.
  • 5. Yılmaz C, Gülen B, Sönmez E, Akbay D, Söğüt Ö, Özdemir S, et al. Serum SCUBE-1 Levels and Return of Spontaneous Circulation Following Cardiopulmonary Resuscitation in Adult Patients. Avicenna J Med. 2022 Sep 5;12(3):148-153.
  • 6. Mermiri M, Mavrovounis G, Chatzis D, Mpoutsikos I, Tsaroucha A, Dova M, et al. Critical emergency medicine and the resuscitative care unit. Acute Crit Care. 2021 Feb;36(1):22-28.
  • 7. Özdemir, S. Optimizing Critical Care in Emergency Departments: A Multidisciplinary Approach. Hastane Öncesi Dergisi. 2024;8(3):330-2.
  • 8. Jackson M, Cairns T. Care of the critically ill patient. Surgery (Oxf). 2021 Jan;39(1):29-36.
  • 9. Beştemir A, Bozdereli Berikol G. Clinical laboratory testing in the emergency department: a six-year analysis. Turkish Journal of Biochemistry. 2023;48(5): 467-74.
  • 10. Özdemir S. Prognostic Biomarkers in Sepsis. Eurasian j Crit Care. 2023;5(3):115-7.
  • 11. Mrazek C, Lippi G, Keppel MH, Felder TK, Oberkofler H, Haschke-Becher E, et al. Errors within the total laboratory testing process, from test selection to medical decision-making - A review of causes, consequences, surveillance and solutions. Biochem Med (Zagreb). 2020 Jun 15;30(2):020502.
  • 12. Özdemir S, Algin A. Evaluation of the ability of the C-reactive protein-to-albumin ratio to predict short-term mortality in patients with COVID-19. J Clin Med Kaz. 2021;18(6):35-9.
  • 13. Seringec Akkececi N, Yildirim Cetin G, Gogebakan H, Acipayam C. The C-Reactive Protein/Albumin Ratio and Complete Blood Count Parameters as Indicators of Disease Activity in Patients with Takayasu Arteritis. Med Sci Monit. 2019 Feb 22;25:1401-9.
  • 14. Akça HŞ, Gürlevik E, Akça MT, Akça H. The Role of C-Reactive Protein and Albumin Combined Indexes in Acute Cholecystitis. IJHSRP. 2022;7(3):309–15.
  • 15. Shi W, Wang Y, Zhao X, Yu T, Li T. CRP/Albumin Has a Promising Prospect as a New Biomarker for the Diagnosis of Periprosthetic Joint Infection. Infect Drug Resist. 2021 Dec 6;14:5145-51.
  • 16. Wu H, Pan L, Meng Z, Liu H, Yang X, Cao Y. C-reactive protein (CRP)/albumin-to-globulin ratio (AGR) is a valuable test for diagnosing periprosthetic joint infection: a single-center retrospective study. J Orthop Traumatol. 2022 Aug 1;23(1):36.
  • 17. Özdemir S, Akça HŞ, Algın A, Eroğlu SE. Can C-reactive protein-to-albumin ratio be a predictor of short-term mortality in community-acquired pneumonia? Ann Clin Anal Med. 2021;12(9):1043-8.
  • 18. Lök U, Gülaçti U, Kafadar H, Kaya H. Clinical Significance of CRP/Albumin Value on Hospitalization and Length of Hospital Stay of Patients with Coronavirus-19: A Prospective Study. KSU Medical Journal. July 2023;18(2):99-105.
  • 19. Özdemir S, Altunok İ. Comparison of the Predictive Ability of the Blood Urea Nitrogen/Albumin, C-Reactive Protein/Albumin, and Lactate/Albumin Ratios for Short-Term Mortality in SARS-CoV-2-Infected Patients. Avicenna J Med. 2023 Feb 23;13(1):43-8.
  • 20. Ranzani OT, Zampieri FG, Forte DN, Azevedo LC, Park M. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PLoS One. 2013;8(3):e59321.
  • 21. Park JE, Chung KS, Song JH, Kim SY, Kim EY, Jung JY, et al. The C-Reactive Protein/Albumin Ratio as a Predictor of Mortality in Critically Ill Patients. J Clin Med. 2018 Oct 8;7(10):333.
  • 22. Bahadirli S, Kurt E. Predictive value of C-reactive protein/albumin ratio in predicting poor outcome of hospitalized patients with COVID-19. J Health Sci Med / JHSM. July 2021;4(4):505-10.
  • 23. Tekyol D, Kılıç M. Usage of the Ranson criteria and neutrophil-lymphocyte ratio measured on presentation to the emergency department in the prediction of mortality in acute pancreatitis. Signa Vitae. 2022; 18(5): 133-7.
  • 24. Akoglu EU, Özdemir S, Rohat Ak, Ozturk TC. The discriminative power of inflammatory markers in patients with mild-to-moderate acute pancreatitis: mean platelet volume, neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, and neutrophil-monocyte product. Southern Clinics of Istanbul Eurasia. 2021; 32: 159-65.
  • 25. Ni J, Wang H, Li Y, Shu Y, Liu Y. Neutrophil to lymphocyte ratio (NLR) as a prognostic marker for in-hospital mortality of patients with sepsis: A secondary analysis based on a single-center, retrospective, cohort study. Medicine (Baltimore). 2019 Nov;98(46):e18029.
  • 26. Akça HŞ, Algin A, Özdemir S, Yilmaz B, Altunok İ. Evaluation of the relationship of hemogram parameters with prognosis in older adults with acute abdominal pathologies. J Health Sci Med /JHSM. March 2022;5(2):385-92.
  • 27. Yılmaz E, Ak R, Doğanay F. Usefulness of the neutrophil-to-lymphocyte ratio in predicting the severity of COVID-19 patients: a retrospective cohort study. Sao Paulo Med J. 2022 Jan-Feb;140(1):81-86.
  • 28. Özkan A, Akça HŞ. The role of combined hematological inflammatory indices in predicting poor outcomes in patients with acute pancreatitis. J Contemp Med. November 2022;12(6):832-8.
  • 29. Buonacera A, Stancanelli B, Colaci M, Malatino L. Neutrophil to Lymphocyte Ratio: An Emerging Marker of the Relationships between the Immune System and Diseases. Int J Mol Sci. 2022 Mar 26;23(7):3636.
  • 30. Taslidere B, Sonmez E, Karatas A, Sakin B, Kazancioğlu R. Can Routine Blood Tests Be Used to Predict the Prognosis of COVID-19 Patients Using Antithrombotic Drugs. Eurasian j Crit Care. 2022;4(2):52-7.
  • 31. Akilli NB, Yortanlı M, Mutlu H, Günaydın YK, Koylu R, Akca HS, et al. Prognostic importance of neutrophil-lymphocyte ratio in critically ill patients: short- and long-term outcomes. Am J Emerg Med. 2014 Dec;32(12):1476-80.
  • 32. Wang H, Lin C, Fan W, Zhang J, Zhang Y, Yao W, et al. Dynamic Changes in the Neutrophil-to-Lymphocyte Ratio Predict the Prognosis of Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization. Cancer Manag Res. 2020 May 14;12:3433-4.
Year 2024, Volume: 6 Issue: 1, 38 - 41, 02.05.2024
https://doi.org/10.55994/ejcc.1435162

Abstract

References

  • 1. Andrews FJ, Nolan JP. Critical care in the emergency department: monitoring the critically ill patient. Emerg Med J. 2006 Jul;23(7):561-4.
  • 2. Özkan A. Comparison of the c-reactive protein-mean arterial pressure ratio with critical care prognostic scoring systems. Ann Clin Anal Med 2022;13(11):1257-61.
  • 3. Tuttle E, Wisecup C, Lemieux E, Wang X, Modrykamien A. Critically ill patients boarding in the emergency department and the association with intensive care unit length of stay and hospital mortality during the COVID-19 pandemic. Proc (Bayl Univ Med Cent). 2022 Jan 11;35(2):145-8.
  • 4. Thim T, Krarup NH, Grove EL, Rohde CV, Løfgren B. Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. Int J Gen Med. 2012;5:117-21.
  • 5. Yılmaz C, Gülen B, Sönmez E, Akbay D, Söğüt Ö, Özdemir S, et al. Serum SCUBE-1 Levels and Return of Spontaneous Circulation Following Cardiopulmonary Resuscitation in Adult Patients. Avicenna J Med. 2022 Sep 5;12(3):148-153.
  • 6. Mermiri M, Mavrovounis G, Chatzis D, Mpoutsikos I, Tsaroucha A, Dova M, et al. Critical emergency medicine and the resuscitative care unit. Acute Crit Care. 2021 Feb;36(1):22-28.
  • 7. Özdemir, S. Optimizing Critical Care in Emergency Departments: A Multidisciplinary Approach. Hastane Öncesi Dergisi. 2024;8(3):330-2.
  • 8. Jackson M, Cairns T. Care of the critically ill patient. Surgery (Oxf). 2021 Jan;39(1):29-36.
  • 9. Beştemir A, Bozdereli Berikol G. Clinical laboratory testing in the emergency department: a six-year analysis. Turkish Journal of Biochemistry. 2023;48(5): 467-74.
  • 10. Özdemir S. Prognostic Biomarkers in Sepsis. Eurasian j Crit Care. 2023;5(3):115-7.
  • 11. Mrazek C, Lippi G, Keppel MH, Felder TK, Oberkofler H, Haschke-Becher E, et al. Errors within the total laboratory testing process, from test selection to medical decision-making - A review of causes, consequences, surveillance and solutions. Biochem Med (Zagreb). 2020 Jun 15;30(2):020502.
  • 12. Özdemir S, Algin A. Evaluation of the ability of the C-reactive protein-to-albumin ratio to predict short-term mortality in patients with COVID-19. J Clin Med Kaz. 2021;18(6):35-9.
  • 13. Seringec Akkececi N, Yildirim Cetin G, Gogebakan H, Acipayam C. The C-Reactive Protein/Albumin Ratio and Complete Blood Count Parameters as Indicators of Disease Activity in Patients with Takayasu Arteritis. Med Sci Monit. 2019 Feb 22;25:1401-9.
  • 14. Akça HŞ, Gürlevik E, Akça MT, Akça H. The Role of C-Reactive Protein and Albumin Combined Indexes in Acute Cholecystitis. IJHSRP. 2022;7(3):309–15.
  • 15. Shi W, Wang Y, Zhao X, Yu T, Li T. CRP/Albumin Has a Promising Prospect as a New Biomarker for the Diagnosis of Periprosthetic Joint Infection. Infect Drug Resist. 2021 Dec 6;14:5145-51.
  • 16. Wu H, Pan L, Meng Z, Liu H, Yang X, Cao Y. C-reactive protein (CRP)/albumin-to-globulin ratio (AGR) is a valuable test for diagnosing periprosthetic joint infection: a single-center retrospective study. J Orthop Traumatol. 2022 Aug 1;23(1):36.
  • 17. Özdemir S, Akça HŞ, Algın A, Eroğlu SE. Can C-reactive protein-to-albumin ratio be a predictor of short-term mortality in community-acquired pneumonia? Ann Clin Anal Med. 2021;12(9):1043-8.
  • 18. Lök U, Gülaçti U, Kafadar H, Kaya H. Clinical Significance of CRP/Albumin Value on Hospitalization and Length of Hospital Stay of Patients with Coronavirus-19: A Prospective Study. KSU Medical Journal. July 2023;18(2):99-105.
  • 19. Özdemir S, Altunok İ. Comparison of the Predictive Ability of the Blood Urea Nitrogen/Albumin, C-Reactive Protein/Albumin, and Lactate/Albumin Ratios for Short-Term Mortality in SARS-CoV-2-Infected Patients. Avicenna J Med. 2023 Feb 23;13(1):43-8.
  • 20. Ranzani OT, Zampieri FG, Forte DN, Azevedo LC, Park M. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PLoS One. 2013;8(3):e59321.
  • 21. Park JE, Chung KS, Song JH, Kim SY, Kim EY, Jung JY, et al. The C-Reactive Protein/Albumin Ratio as a Predictor of Mortality in Critically Ill Patients. J Clin Med. 2018 Oct 8;7(10):333.
  • 22. Bahadirli S, Kurt E. Predictive value of C-reactive protein/albumin ratio in predicting poor outcome of hospitalized patients with COVID-19. J Health Sci Med / JHSM. July 2021;4(4):505-10.
  • 23. Tekyol D, Kılıç M. Usage of the Ranson criteria and neutrophil-lymphocyte ratio measured on presentation to the emergency department in the prediction of mortality in acute pancreatitis. Signa Vitae. 2022; 18(5): 133-7.
  • 24. Akoglu EU, Özdemir S, Rohat Ak, Ozturk TC. The discriminative power of inflammatory markers in patients with mild-to-moderate acute pancreatitis: mean platelet volume, neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, and neutrophil-monocyte product. Southern Clinics of Istanbul Eurasia. 2021; 32: 159-65.
  • 25. Ni J, Wang H, Li Y, Shu Y, Liu Y. Neutrophil to lymphocyte ratio (NLR) as a prognostic marker for in-hospital mortality of patients with sepsis: A secondary analysis based on a single-center, retrospective, cohort study. Medicine (Baltimore). 2019 Nov;98(46):e18029.
  • 26. Akça HŞ, Algin A, Özdemir S, Yilmaz B, Altunok İ. Evaluation of the relationship of hemogram parameters with prognosis in older adults with acute abdominal pathologies. J Health Sci Med /JHSM. March 2022;5(2):385-92.
  • 27. Yılmaz E, Ak R, Doğanay F. Usefulness of the neutrophil-to-lymphocyte ratio in predicting the severity of COVID-19 patients: a retrospective cohort study. Sao Paulo Med J. 2022 Jan-Feb;140(1):81-86.
  • 28. Özkan A, Akça HŞ. The role of combined hematological inflammatory indices in predicting poor outcomes in patients with acute pancreatitis. J Contemp Med. November 2022;12(6):832-8.
  • 29. Buonacera A, Stancanelli B, Colaci M, Malatino L. Neutrophil to Lymphocyte Ratio: An Emerging Marker of the Relationships between the Immune System and Diseases. Int J Mol Sci. 2022 Mar 26;23(7):3636.
  • 30. Taslidere B, Sonmez E, Karatas A, Sakin B, Kazancioğlu R. Can Routine Blood Tests Be Used to Predict the Prognosis of COVID-19 Patients Using Antithrombotic Drugs. Eurasian j Crit Care. 2022;4(2):52-7.
  • 31. Akilli NB, Yortanlı M, Mutlu H, Günaydın YK, Koylu R, Akca HS, et al. Prognostic importance of neutrophil-lymphocyte ratio in critically ill patients: short- and long-term outcomes. Am J Emerg Med. 2014 Dec;32(12):1476-80.
  • 32. Wang H, Lin C, Fan W, Zhang J, Zhang Y, Yao W, et al. Dynamic Changes in the Neutrophil-to-Lymphocyte Ratio Predict the Prognosis of Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization. Cancer Manag Res. 2020 May 14;12:3433-4.
There are 32 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Review Article
Authors

Abuzer Özkan 0000-0003-4284-0086

Publication Date May 2, 2024
Submission Date February 11, 2024
Acceptance Date April 14, 2024
Published in Issue Year 2024 Volume: 6 Issue: 1

Cite

AMA Özkan A. CRP/Albumin Ratio and NLR in Recognizing Critically Ill Patients. Eurasian j Crit Care. May 2024;6(1):38-41. doi:10.55994/ejcc.1435162

Indexing and Abstracting

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