Inflammation scores based on C-reactive protein and albumin predict mortality in hospitalized older patients independent of the admission diagnosis.

IF 5.2 2区 医学 Q1 GERIATRICS & GERONTOLOGY
Mirko Di Rosa, Jacopo Sabbatinelli, Angelica Giuliani, Miriam Carella, Daniele Magro, Leonardo Biscetti, Luca Soraci, Francesco Spannella, Massimiliano Fedecostante, Federica Lenci, Elena Tortato, Lorenzo Pimpini, Maurizio Burattini, Sara Cecchini, Antonio Cherubini, Anna Rita Bonfigli, Maria Capalbo, Antonio Domenico Procopio, Carmela Rita Balistreri, Fabiola Olivieri
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引用次数: 0

Abstract

Systemic inflammation significantly increases the risk of short- and long-term mortality in geriatric hospitalized patients. To predict mortality in older patients with various age-related diseases and infections, including COVID-19, inflammatory biomarkers such as the C-reactive protein (CRP) to albumin ratio (CAR), and related scores and indexes, i.e. Glasgow Prognostic Score (GPS), modified GPS (mGPS), and high sensitivity (hs)-mGPS, have been increasingly utilized. Despite their easy affordability and widespread availability, these biomarkers are predominantly assessed for clinical purposes rather than predictive applications, leading to their underutilization in hospitalized older patients. In this study, we investigated the association of CAR, GPS, mGPS, and hs-mGPS with short-term mortality in 3,206 geriatric hospitalized patients admitted for acute conditions, irrespective of admission diagnosis. We observed that unit increases of CAR, and the highest classes of GPS, mGPS, and hs-mGPS were significantly associated with a two- to threefold increased risk of death, even adjusting the risk for different confounding variables. Interestingly, a hs-mGPS of 2 showed the highest effect size. Furthermore, gender analysis indicated a stronger association between all CRP-albumin based parameters and mortality in men, underscoring the gender-specific relevance of inflammation-based circulating parameters in mortality prediction. In conclusion, scores based on serum CRP and albumin levels offer additional guidance for the stratification of in-hospital mortality risk in older patients by providing additional information on the degree of systemic inflammation.

基于 C 反应蛋白和白蛋白的炎症评分可预测住院老年患者的死亡率,与入院诊断无关。
全身炎症会大大增加老年住院患者的短期和长期死亡风险。为了预测患有各种老年相关疾病和感染(包括 COVID-19)的老年患者的死亡率,C-反应蛋白(CRP)与白蛋白比值(CAR)等炎症生物标志物以及相关评分和指数(即格拉斯哥预后评分(GPS)、改良 GPS(mGPS)和高灵敏度(hs)-mGPS)已被越来越多地采用。尽管这些生物标记物价格低廉且广泛使用,但其评估主要用于临床目的,而非预测性应用,导致其在住院老年患者中使用不足。在这项研究中,我们调查了 3206 名因急性病住院的老年病人的 CAR、GPS、mGPS 和 hs-mGPS 与短期死亡率的关系,无论其入院诊断如何。我们观察到,即使根据不同的混杂变量对风险进行调整,CAR 单位的增加以及 GPS、mGPS 和 hs-mGPS 的最高等级也与死亡风险增加两到三倍有显著关系。有趣的是,2 级的 hs-mGPS 显示出最高的效应规模。此外,性别分析表明,基于 CRP- 白蛋白的所有参数与男性死亡率之间的关联性更强,这突出表明了基于炎症的循环参数在预测死亡率方面的性别特异性。总之,基于血清 CRP 和白蛋白水平的评分通过提供有关全身炎症程度的额外信息,为老年患者院内死亡风险分层提供了额外指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Immunity & Ageing
Immunity & Ageing GERIATRICS & GERONTOLOGY-IMMUNOLOGY
CiteScore
10.20
自引率
3.80%
发文量
55
期刊介绍: Immunity & Ageing is a specialist open access journal that was first published in 2004. The journal focuses on the impact of ageing on immune systems, the influence of aged immune systems on organismal well-being and longevity, age-associated diseases with immune etiology, and potential immune interventions to increase health span. All articles published in Immunity & Ageing are indexed in the following databases: Biological Abstracts, BIOSIS, CAS, Citebase, DOAJ, Embase, Google Scholar, Journal Citation Reports/Science Edition, OAIster, PubMed, PubMed Central, Science Citation Index Expanded, SCImago, Scopus, SOCOLAR, and Zetoc.
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