ABSTRACT
Objective:To investigate the predictive value of albumin/fibrinogen ratio (AFR) for 28-d mortality in patients with sepsis.Methods:A total of 186 patients with sepsis admitted to the Intensive Care Unit of the First Affiliated Hospital of Xinjiang Medical University from January 2019 to December 2021 were studied retrospectively. They were divided into the survival group ( n=124) and death group ( n=62) according to the 28-d survival conditions. Clinical data of each group within 24 h after admission were recorded, including age, sex, underlying diseases, white blood cell count, albumin, fibrinogen (FIB), PCT, CRP and other laboratory examination indexes. APACHEⅡ scores and SOFA scores were recorded at the time of admission. Cox regression was used to analyze the influence of each index on the prognosis of patients. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of AFR for 28-d mortality in patients with sepsis. Kaplan-Meier method was used to draw survival curves under different AFR levels for survival analysis. Pearson correlation was used to analyze the relationship between AFR and APACHEⅡ score. Rseults:Age, number of patients with septic shock, mechanical ventilation, APACHEⅡ score, SOFA score, blood lactic acid and fibrinogen increased significantly in the death group ( P<0.05), while albumin and AFR were significantly decreased ( P<0.001). ROC curve analysis showed that the area under the curve of AFR in predicting 28-d mortality risk of patients with sepsis was 0.900. When the cut-off value of AFR was 7.64, the sensitivity was 80.0% and the specificity was 85.5%. Kaplan-Meier survival analysis showed that patients with AFR >7.64 had better prognosis. Cox regression analysis showed that AFR, APACHEⅡ score and the presence of septic shock were independent risk factors affecting the prognosis of patients with sepsis. AFR was strongly correlated with APACHEⅡ score ( r=-0.462, P<0.001). Conclusions:As a simple, effective and safe biomarker, AFR has a certain predictive value for 28-d mortality risk in patients with sepsis.
ABSTRACT
OBJECTIVE@#To investigate the value of pre-treatment albumin/fibrinogen ratio (AFR) on the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).@*METHODS@#The data of DLBCL patients in the Affiliated Hospital of North Sichuan Medical College from April 2014 to March 2021 were retrieved, and 111 newly diagnosed patients who completed at least 4 cycles of R-CHOP or R-CHOP-like chemotherapy with complete data were included in the study. The clinical, laboratory examination and follow-up data of the patients were collected, and the receiver operating characteristic curve (ROC) was drawn according to patients' AFR before treatment and the survival status at the end of the follow-up, which could be used to preliminarily evaluate the predictive value of AFR for disease progression and patients' survival outcome. Furthermore, the correlation of AFR with the clinical and laboratory characteristics, progression-free survival (PFS) and overall survival (OS) was analyzed, and finally, univariate and multivariate Cox proportional hazard regression models were used to analyze factors affecting PFS and OS of DLBCL patients.@*RESULTS@#The ROC curve indicated that AFR level had a moderate predictive value for PFS and OS in DLBCL patients, with the area under the curve (AUC) of 0.616 (P =0.039) and 0.666 (P =0.004), respectively, and the optimal cut-off values were both 9.06 for PFS and OS. Compared with high-AFR (≥9.06) group, the low-AFR (<9.06) group had a higher proportion of patients with Lugano III-IV stage ( P <0.001), elevated lactate dehydrogenase (P =0.007) and B symptoms (P =0.038). The interim analysis of response showed that the overall response rate (ORR) in the high-AFR group was 89.7%, which was significantly higher than 62.8% in the low-AFR group (P =0.001). With a median follow-up of 18.5 (3-77) months, the median PFS of the high-AFR group was not reached, which was significantly superior to 17 months of the low-AFR group (P =0.009). Similarly, the median OS of high-AFR group was not reached, either, which was significantly superior to 48 months of the low-AFR group (P < 0.001). In multivariate Cox regression analysis, AFR <9.06 was an independent risk factor both for PFS and OS (HR PFS=2.047, P =0.039; HR OS=4.854, P =0.001).@*CONCLUSION@#Pre-treatment AFR has a significant value for the prognosis evaluation in newly diagnosed DLBCL patients.
Subject(s)
Humans , Prognosis , Fibrinogen , Disease-Free Survival , Albumins/therapeutic use , Hemostatics/therapeutic use , Lymphoma, Large B-Cell, Diffuse/drug therapy , Retrospective Studies , Antineoplastic Combined Chemotherapy Protocols/therapeutic useABSTRACT
Objective:To investigate the clinical significance of detecting serum 25-hydroxyl-vitamin D [25(OH)D] level and albumin/fibrinogen ratio (AFR) in patients with rheumatoid arthritis (RA).Methods:This retrospective study included 131 patients (95 patients with RA and 36 with arthralgia excluding autoimmune diseases), who were treated in Bozhou People′s Hospital from May 2017 to January 2020. Forty healthy controls underwent health checkups during the same period served as healthy control. RA group was divided into high (>5.1, 25 cases), medium (3.2<DAS28-CRP≤5.1), 40 cases and low (≤3.2, 30 cases) subgroups by disease activity (DAS28-CRP) based on 28 joint counts and the level of C-reactive protein(CRP). RA patients were further divided into normal (≥30 ng/ml, 17 cases), insufficient (20 ng/ml ≤ 25(OH)D<30 ng/ml, 31 cases) and deficient (<20 ng/ml, 47 cases) subgroups according to the serum 25(OH)D concentration; 4 age subgroups (≤44 years of 21 cases, 45-59 years of 43 cases, 60-74 years of 21 cases and ≥75 years of 10 cases); 2 sex subgroups (79 female and 16 male). Serum 25(OH)D, albumin and fibrinogen levels were measured in all patients and healthy controls. The general clinical and laboratory indexes were collected and analyzed. Multivariate logistic regression analyses were performed to determine the independent risk factors of RA.Results:The serum 25(OH)D concentration and albumin/fibrinogen ratio were lower ( P<0.05) in rheumatoid arthritis patients than those in other groups, and serum 25(OH)D insufficiency or deficiency was evidenced in 82.11% (78/95) rheumatoid arthritis patients. Among patients with rheumatoid arthritis, the levels of 25(OH)D were apparently different in various age groups ( P<0.05) and significantly lower in female than those in male ( P<0.05). In addition, a significant negative correlation was found between AFR and DAS28-CRP ( r=-0.497, P<0.01). Logistic regression analysis showed that 25(OH)D ( OR=0.852, 95% CI: 0.768-0.944, P=0.002) and AFR ( OR=0.626, 95% CI 0.480-0.817, P=0.001), RF-IgM ( OR=1.044, 95% CI 1.019-1.069, P<0.001) and anti-CCP antibodies ( OR=1.017, 95% CI 1.002-1.032, P=0.030) were independent risk factors for disease activity in RA patients. Conclusions:The serum 25(OH)D and AFR levels are significantly reduced and 5(OH)D insufficiency or deficiency is common in RA patients, suggesting that low levels of 25(OH)D and AFR may be the risk factors reflecting the RA disease activity.