Creatinine-to-albumin ratio for early ICU-course (first 24 hours) risk stratification of mortality in critically ill patients with gastrointestinal bleeding: A retrospective cohort study - PubMed
5 hours ago
- #gastrointestinal bleeding
- #creatinine-to-albumin ratio
- #ICU mortality
- The study investigates the creatinine-to-albumin ratio (CAR) as a prognostic marker for mortality in critically ill patients with gastrointestinal bleeding (GIB) during their first 24 hours in the ICU.
- Using data from the MIMIC-IV database (1,611 patients), results show that higher CAR levels are strongly associated with increased mortality rates, with the highest quartile having 31.3% 28-day mortality compared to 7.2% in the lowest quartile.
- CAR independently predicts mortality (28-day HR 1.29, 95% CI 1.09-1.53) and outperforms individual markers like creatinine or albumin, with moderate discrimination in ROC analysis.
- A nomogram incorporating five predictors (sepsis, APTT, CAR, TB, and BUN) was developed and validated externally (eICU-CRD cohort), showing strong discrimination (28-day AUC 0.779) and good calibration.
- The findings suggest CAR can aid in early ICU risk stratification, but any identified inflection points from spline analyses require further validation before clinical use.