Uğur KÜÇÜK, Emine GAZİ, Bahadır KIRILMAZ

Roles of the Ratio of C-Reactive Protein to Serum and Pericardial Fluid Albumin Levels in Predicting in-Hospital Mortality in Patients Undergoing Pericardiocentesis

Background: Pericardial effusions occur due to excessive fluid accumulation in the pericardial space. In effusions not responding to medical treatment, pericardiocentesis is an important method of treatment affecting prognosis. CRP/albumin ratios have been found to be associated with prognosis in conditions such as cardiac failure, sepsis, malignancy, and the routinely available parameters used for the prognosis prediction of the patients who underwent pericardiocentesis are limited. This study aimed to examine the usability of CRP/albumin and CRP/pericardial fluid albumin (CRP/pf-albumin) ratios as predictors for in-hospital mortality of patients who underwent surgery pericardiocentesis. Methods: This study included 54 patients (25 females and 29 males). All patients underwent pericardiocentesis. Results: The average age was 67±14 years. When the groups were compared with each other, CRP, CRP/albumin ratio and CRP/ pf-Albumin ratio were higher in the in-hospital mortality group compared to the group discharged with recovery [19 (14-25), 6.3 (1-30), p

Keywords:

C-Reactive Protein/Albumin Ratio Pericardial Fluid Albumin, Mortality, Hospitalized Patients.,

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1. Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC) Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36(42):2921-2964.
2. Roy CL, Minor MA, Brookhart MA, Choudhry NK. Does this patient with a pericardial effusion have cardiac tamponade? JAMA. 2007; 297(16):1810-1818.
3. Albugami S, Al-Husayni F, AlMalki A, Dumyati M, Zakri Y, AlRahimi J. Etiology of Pericardial Effusion and Outcomes Post Pericardiocentesis in the Western Region of Saudi Arabia: A Singlecenter Experience. Cureus. 2020;12(1):e6627.
4. Michalska-Kasiczak M, Bielecka-Dabrowa A, von Haehling S, Anker SD, Rysz J, Banach M. Biomarkers, myocardial fibrosis and co-morbidities in heart failure with preserved ejection fraction: an overview. Arch Med Sci. 2018;14(4):890-909.
5. Wang W, Ren D, Wang CS, Li T, Yao HC. High sensitivity C-reactive protein to prealbumin ratio measurement as a marker of the prognosis in acute coronary syndrome. Sci Rep. 2019;9(1):11583.
6. Yu B, Yang P, Xu X, Shao L. C-reactive protein for predicting all-cause mortality in patients with acute ischemic stroke: a meta-analysis. Biosci Rep. 2019;39(2):BSR20181135.
7. Utariani A, Rahardjo E, Perdanakusuma DS. Effects of Albumin Infusion on Serum Levels of Albumin, Proinflammatory Cytokines (TNF-α, IL-1, and IL-6), CRP, and MMP-8; Tissue Expression of EGRF, ERK1, ERK2, TGF-β, Collagen, and MMP-8; and Wound Healing in Sprague Dawley Rats. Int J Inflam. 2020;2020:3254017.
8. Wang R, He M, Ou X, Xie X, Kang Y. CRP Albumin ratio is positively associated with poor outcome in patients with traumatic brain injury. Clin Neurol Neurosurg. 2020;195:106051.
9. Maisch B, Ristić AD, Seferović PM, Tsang TS. Interventional Pericardiology: Pericardiocentesis, Pericardioscopy, Pericardial Biopsy, Balloon Pericardiotomy and Intrapericardial Therapy. 1st ed. Heidelberg: Springer Medizin Verlag, 2011.
10. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14.
11. Krikorian JG, & Mancock EW. Pericardiocentesis. Am J Med, 1978;65(5):808-14.
12. Jeong TD, Jang S, Park CJ, Chi HS. Prognostic relevance of pericardial effusion in patients with malignant diseases. Korean J Hematol. 2012;47(3):237-238.
13. Rhodes B, Fürnrohr BG, Vyse TJ. C-reactive protein in rheumatology: biology and genetics. Nat Rev Rheumatol. 2011;7(5):282-289.
14. Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol. 2018;9:754.
15. Reilly SM, Saltiel AR. Adapting to obesity with adipose tissue inflammation. Nat Rev Endocrinol. 2017;13(11):633–43.
16. Rauchhaus M, Doehner W, Francis DP, Davos C, Kemp M, Liebenthal C, et al. Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation 2000;102(25):3060-3067.
17. Gotsman I, Shauer A, Zwas DR, Tahiroglu I, Lotan C, Keren A. Low serum albumin: A significant predictor of reduced survival in patients with chronic heart failure. Clin Cardiol. 2019;42(3):365-372.
18. Kudou K, Saeki H, Nakashima Y, Kamori T, Kawazoe T, Haruta Y, et al. C-reactive protein/albumin ratio is a poor prognostic factor of esophagogastric junction and upper gastric cancer. J Gastroenterol Hepatol. 2019;34(2):355-363.
19. Nurmi AM, Mustonen HK, Stenman UH, Seppänen HE, Haglund CH. Combining CRP and CA19-9 in a novel prognostic score in pancreatic ductal adenocarcinoma. Sci Rep. 2021;11(1):781.
20. Yu J, Liu H, Zeng X, Zhao Y, Jiang D, Lu H, et al. Prognostic and clinicopathological significance of C-reactive protein/albumin ratio (CAR) in patients with gastric cancer: A meta-analysis. PLoS One. 2021;16(4):e0250295.
21. Faloppi L, Del Prete M, Casadei Gardini A, Santini D, Silvestris N, Bianconi M, et al. The correlation between LDH serum levels and clinical outcome in advanced biliary tract cancer patients treated with first line chemotherapy. Sci Rep. 2016;6:24136.