Prognostic Utility of C-Reactive Protein / Albumin Ratio in Cirrhotic Patients

Backgroundand Aims: In this study, we investigated the relationship between C-reaktive protein (CRP)/Albumin ratio (CAR) and hepatocellular carcinoma (HCC), hepatic encephalopathy (HES), mortality, Child-Pugh and MELD scores in newly diagnosed cirrhotic patients. Material and Methods: This study was performed retrospectively by examining newly diagnosed cirrhotic patients records who applied to Gastroenterology and Hepatology polyclinic between 2011 and 2017. Patients who diagnosed with HES, HCC or spontaneous bacterial peritonitis at admission and those younger than 18 years old were excluded from the study. Results: The study population was consisted of 118 patients, 78 men (66.1%) and 40 women (33.9%). The mean age of the patients was 50.3±11.7 years. The most common etiologic factors of cirrhosis were hepatitis B (37.3%), cryptogenic (17.8%) and hepatitis C (11.9%). The mean follow-up period of the patients was 48 months. In the multivariate stepwise Cox regression model in which risk factors were included; HES development (HR: 4,21; p=0,001), initial MELD score (HR: 1,17; p <0.001) and CAR (HR=1.22; p <0.001) were found to be independent predictors for mortality risk. A 1% increase in CAR was found to increase the mortality risk 1.22-fold. The cut-off value of CAR for predicting mortality was found ≥2.4 with 77.1% sensitivity and 95.2% specificity. Devolopment of HES (35.5% vs 10.3%, p=0.004), the mean Child-Pugh score (7.4±1.9 vs 6.4±1.6, p <0.001), the mean MELD score (14,2±3,7 vs 11,8±4,1; p <0,001) and the proportion of dead patients (87,1% vs 9,2%, p <0,001) were significantly higher in patients with CAR 2.4 and above. Conclusion: CAR is a easily measured parameter with high specificity that can be used for prediction of mortality and cirrhosis complications in newly diagnostic cirrhotic patients