Clinical Study On The Prognosis Of Patients With AECOPD In The Prediction Of C-reactive Protein And Albumin Ratio

Objective Through retrospective analysis to observe the changes of Reactive Protein(CRP)to Albumin(Alb)Ratio on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to discuss the predictive value of this index for estimating clinical prognosis of patients AECOPD.Methods Patients diagnosed with AECOPD enrolled in our hospital were collected from January 2015 to November 2017,and there were a total of 156 patients with AECOPD were selected to our study after strict screening.The general information and clinical laboratory data which were measured in the first 24 hours would be extracted.The overall survival(OS),which is the main end point,was calculated from the date in hospital to the date of the latest follow-up of this study(November 2017)or death.The optimal cutoff value for CRP/Alb ratio was calculated with the Youden index,and all patients were divided into survival group and deadth group according to the follow-up results.The differences of general information and laboratory index in two groups were compared by using the Chi-square and T test.Receiver operating characteristic(ROC)analyses were performed with overall survival(OS)as the end point,and the optimal cutoff values for continuous prognostic variables were determined at the point of the maximal Youden index.The univariate and multivariate analyses were performed by Cox regression model to determine the independent prognostic factors.The survival curves were generated by using Kaplan–Meier analysis and evaluated by log rank test.All the statistical analyses were considered significant at two-tailed P<0.05.Results(1).The comparison results of general information and laboratory data showed that,(1)General information:there was no significant difference of the general information(gender,age,smoking history,course of diseases,the number of exacerbations in the past 1 years and whether merger and basis of disease,etc)between groups(P<0.05).(2)Clinical laboratory data:there was significant difference of the laboratory data(FEV1%,CRP,CRP/Alb,Alb,neutrophil,lymphocyte,hemoglobin,platelet,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),fibrinogen and GPS)between two groups(P<0.05).(2).ROC analysis indicated that the area under curve(AUC)of FEV1%,CRP,CRP/Alb,NLR,PLR,GPS and fibrinogen were 0.66,0.84,0.81,0.87,0.82,0.75,0.77,0.79,respectively.The AUC of CRP/Alb ratio was the largest which indicated that it was the best indexes that predict the prognosis of acute exacerbation of AECOPD.(3).The COX analysis suggested that FEV1%,Alb,CRP/Alb ratio and fibrinogen were independent risk factors of patient with poor prognosis in AECOPD.(4).The survival curves revealed that patients with higher CRP/Alb ratio had significantly worse survival than those with lower CRP/Alb ratio(?~2=24.24,P<0.001).Conclusion1.CRP/Alb ratio was an important independent risk factors for the prognosis of patients with AECOPD.2.CRP/Alb ratio could be used as an positive prediction index to judge the prognosis of patients with AECOPD,the higher level of CRP/Alb ratio indicating the worse condition and the poorer prognosis.3.CRP/Alb ratio was an effective inflammation-based prognostic indicator in AECOPD,which potentially had a discriminatory ability superior to that of other inflammatory indicators including single CRP,single Alb,NLR,PLR and GPS.