The Relationship Between C Reactive Protein /albumin Ratio and 1-Year Mortality in Hospitalized Elderly Copd Patients with Acute Exacerbation

Introduction: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality. C-reactive protein (CRP) is often elevated with acute infective and inflammatory situations. Hypoalbuminemia may be linked to chronic diseases and malnutrition. Here, we investigated the relationship between 1-year mortality and CRP/albumin ratio (CAR) among hospitalized elderly patients with COPD acute exacerbation. Materials and method: The records of patients who were hospitalized with COPD diagnosis in the internal medicine and chest diseases clinics of Kafkas University Medical Faculty Hospital between January 2014 and May 2017 were retrospectively evaluated to determine whether selected patients had died within 1 year of hospitalization. The patients who died (Group 1) and those who were living (Group 2) were compared in terms of various parameters, especially CAR. Results: In Group 1, CRP levels were high and albumin levels were significantly lower; the CAR ratio in group 1 was 0.36 (0.29-0.64), which was significantly elevated, compared with that of Group 2 (0.09; 0.03-0.27). In the multivariate analysis, independent predictors of 1-year mortality were CAR [1.116(1.025-1.216), p=0.011], smoking (packs/year) [1.135 (1.082-1.190), p<0.05], pH [0.001 (0-0.14)], BODE index [1.693 (1.157-2.478)], and FEV1/FVC [0.911 (0.846-0.980)]. Area under the curve values of CAR for 1-year mortality were significantly higher than the values of both albumin and CRP alone (p<0.05). Conclusion: The CRP/albumin ratio is an independent predictor of 1-year mortality in patients with COPD. More comprehensive prospective studies are needed to confirm this finding.