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Erschienen in: Neurological Sciences 8/2021

27.11.2020 | Original Article

Clinical value of C-reactive protein/albumin ratio in Guillain-Barré syndrome

verfasst von: Pingping Ning, Baiyuan Yang, Xinglong Yang, Hongyan Huang, Qiuyan Shen, Quanzhen Zhao, Haitao Lu, Li Yang, Sijia Tian, Yanming Xu

Erschienen in: Neurological Sciences | Ausgabe 8/2021

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Abstract

Background

Respiratory failure in patients with Guillain-Barré syndrome (GBS) can lead to serious complications and dysfunctions, emphasizing the importance of early detection. The C-reactive protein-to-albumin ratio (CAR) is emerging as a novel inflammatory marker for predicting neurological outcome. We aimed to identify the association of CAR with respiratory failure and short-term outcome in GBS patients.

Methods

A total of 200 patients diagnosed with GBS were retrospectively analyzed. Data were collected from an electronic database. The associations of C-reactive protein (CRP), albumin, and CAR at admission with outcomes were evaluated by logistic regression analysis. Using receiver operating characteristic curves, we calculated the cutoff value for the CAR and compared its discriminatory power with that of C-reactive protein alone.

Results

Fifty-two (26%) patients showed poor short-term outcome, and 50 (25%) developed respiratory failure. CAR > 0.21 was an independent predictor of respiratory failure, and CAR > 0.19 was an independent predictor of poor short-term outcome. CAR showed a better predictive value than CRP alone. In addition, the c-index of the predictive nomogram for respiratory failure was higher when it included CAR (0.962) than when it did not (0.958). A similar result was observed for the predictive nomogram for poor short-term outcome (0.953 vs 0.947).

Conclusion

CAR > 0.21, a novel inflammatory biomarker, is independently associated with the occurrence of respiratory failure in GBS patients, while CAR > 0.19 is independently associated with poor short-term outcome. CAR may help identify GBS patients at high risk of poor prognosis.
Literatur
1.
Zurück zum Zitat van Koningsveld R, Steyerberg EW, Hughes RA, Swan AV, van Doorn PA, Jacobs BC (2007) A clinical prognostic scoring system for Guillain-Barre syndrome. Lancet Neurol 6(7):589–594CrossRef van Koningsveld R, Steyerberg EW, Hughes RA, Swan AV, van Doorn PA, Jacobs BC (2007) A clinical prognostic scoring system for Guillain-Barre syndrome. Lancet Neurol 6(7):589–594CrossRef
2.
Zurück zum Zitat McGrogan A, Madle GC, Seaman HE, de Vries CS (2009) The epidemiology of Guillain-Barre syndrome worldwide. A systematic literature review. Neuroepidemiology. 32(2):150–163CrossRef McGrogan A, Madle GC, Seaman HE, de Vries CS (2009) The epidemiology of Guillain-Barre syndrome worldwide. A systematic literature review. Neuroepidemiology. 32(2):150–163CrossRef
3.
Zurück zum Zitat Dhar R, Stitt L, Hahn AF (2008) The morbidity and outcome of patients with Guillain-Barre syndrome admitted to the intensive care unit. J Neurol Sci 264(1–2):121–128CrossRef Dhar R, Stitt L, Hahn AF (2008) The morbidity and outcome of patients with Guillain-Barre syndrome admitted to the intensive care unit. J Neurol Sci 264(1–2):121–128CrossRef
4.
Zurück zum Zitat Fletcher DD, Lawn ND, Wolter TD, Wijdicks EF (2000) Long-term outcome in patients with Guillain-Barre syndrome requiring mechanical ventilation. Neurology. 54(12):2311–2315CrossRef Fletcher DD, Lawn ND, Wolter TD, Wijdicks EF (2000) Long-term outcome in patients with Guillain-Barre syndrome requiring mechanical ventilation. Neurology. 54(12):2311–2315CrossRef
5.
Zurück zum Zitat Rees JH, Thompson RD, Smeeton NC, Hughes RA (1998) Epidemiological study of Guillain-Barre syndrome in south east England. J Neurol Neurosurg Psychiatry 64(1):74–77CrossRef Rees JH, Thompson RD, Smeeton NC, Hughes RA (1998) Epidemiological study of Guillain-Barre syndrome in south east England. J Neurol Neurosurg Psychiatry 64(1):74–77CrossRef
6.
Zurück zum Zitat Winer JB, Hughes RA, Osmond C (1988) A prospective study of acute idiopathic neuropathy. I. Clinical features and their prognostic value. J Neurol Neurosurg Psychiatry 51(5):605–612CrossRef Winer JB, Hughes RA, Osmond C (1988) A prospective study of acute idiopathic neuropathy. I. Clinical features and their prognostic value. J Neurol Neurosurg Psychiatry 51(5):605–612CrossRef
7.
Zurück zum Zitat McMillan DC (2009) Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care 12(3):223–226CrossRef McMillan DC (2009) Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care 12(3):223–226CrossRef
8.
Zurück zum Zitat Kaplan M, Ates I, Akpinar MY, Yuksel M, Kuzu UB, Kacar S, Coskun O, Kayacetin E (2017) Predictive value of C-reactive protein/albumin ratio in acute pancreatitis. Hepatobiliary Pancreat Dis Int 16(4):424–430CrossRef Kaplan M, Ates I, Akpinar MY, Yuksel M, Kuzu UB, Kacar S, Coskun O, Kayacetin E (2017) Predictive value of C-reactive protein/albumin ratio in acute pancreatitis. Hepatobiliary Pancreat Dis Int 16(4):424–430CrossRef
9.
Zurück zum Zitat Lelubre C, Anselin S, Zouaoui Boudjeltia K, Biston P, Piagnerelli M (2013) Interpretation of C-reactive protein concentrations in critically ill patients. Biomed Res Int 2013:124021CrossRef Lelubre C, Anselin S, Zouaoui Boudjeltia K, Biston P, Piagnerelli M (2013) Interpretation of C-reactive protein concentrations in critically ill patients. Biomed Res Int 2013:124021CrossRef
10.
Zurück zum Zitat Lee KJ, Kim HM, Choi JS, Kim YJ, Kim YS, Cho JH (2016) Comparison of predictive systems in severe acute pancreatitis according to the revised Atlanta Classification. Pancreas. 45(1):46–50CrossRef Lee KJ, Kim HM, Choi JS, Kim YJ, Kim YS, Cho JH (2016) Comparison of predictive systems in severe acute pancreatitis according to the revised Atlanta Classification. Pancreas. 45(1):46–50CrossRef
11.
Zurück zum Zitat Altaweel YA, Abdelaziz S, Fathy HA, AbdelBadea S (2018) Correlative study between C-reactive protein, clinical severity, and nerve conduction studies in Guillain-Barre syndrome. Egypt J Neurol Psychiatr Neurosurg 54(1):4CrossRef Altaweel YA, Abdelaziz S, Fathy HA, AbdelBadea S (2018) Correlative study between C-reactive protein, clinical severity, and nerve conduction studies in Guillain-Barre syndrome. Egypt J Neurol Psychiatr Neurosurg 54(1):4CrossRef
12.
Zurück zum Zitat Ethemoglu O, Calik M (2018) Effect of serum inflammatory markers on the prognosis of adult and pediatric patients with Guillain-Barre syndrome. Neuropsychiatr Dis Treat 14:1255–1260CrossRef Ethemoglu O, Calik M (2018) Effect of serum inflammatory markers on the prognosis of adult and pediatric patients with Guillain-Barre syndrome. Neuropsychiatr Dis Treat 14:1255–1260CrossRef
13.
Zurück zum Zitat Tunc A (2019) Early predictors of functional disability in Guillain-Barre syndrome. Acta Neurol Belg 119(4):555–559CrossRef Tunc A (2019) Early predictors of functional disability in Guillain-Barre syndrome. Acta Neurol Belg 119(4):555–559CrossRef
14.
Zurück zum Zitat Li X, Li B, Zeng H, Wang S, Sun X, Yu Y, Wang L, Yu J (2019) Prognostic value of dynamic albumin-to-alkaline phosphatase ratio in limited stage small-cell lung cancer. Future Oncol 15(9):995–1006CrossRef Li X, Li B, Zeng H, Wang S, Sun X, Yu Y, Wang L, Yu J (2019) Prognostic value of dynamic albumin-to-alkaline phosphatase ratio in limited stage small-cell lung cancer. Future Oncol 15(9):995–1006CrossRef
15.
Zurück zum Zitat Zhang D, Yan H, Wei Y, Liu X, Zhuang Z, Dai W, Li J, Li W, Hang C (2019) C-reactive protein/albumin ratio correlates with disease severity and predicts outcome in patients with aneurysmal subarachnoid hemorrhage. Front Neurol 10:1186CrossRef Zhang D, Yan H, Wei Y, Liu X, Zhuang Z, Dai W, Li J, Li W, Hang C (2019) C-reactive protein/albumin ratio correlates with disease severity and predicts outcome in patients with aneurysmal subarachnoid hemorrhage. Front Neurol 10:1186CrossRef
16.
Zurück zum Zitat Moon JS, Ahn SS, Park YB, Lee SK, Lee SW (2018) C-reactive protein to serum albumin ratio is an independent predictor of all-cause mortality in patients with ANCA-associated vasculitis. Yonsei Med J 59(7):865–871CrossRef Moon JS, Ahn SS, Park YB, Lee SK, Lee SW (2018) C-reactive protein to serum albumin ratio is an independent predictor of all-cause mortality in patients with ANCA-associated vasculitis. Yonsei Med J 59(7):865–871CrossRef
17.
Zurück zum Zitat Ge X, Cao Y, Wang H, Ding C, Tian H, Zhang X, Gong J, Zhu W, Li N (2017) Diagnostic accuracy of the postoperative ratio of C-reactive protein to albumin for complications after colorectal surgery. World J Surg Oncol. 15(1):15CrossRef Ge X, Cao Y, Wang H, Ding C, Tian H, Zhang X, Gong J, Zhu W, Li N (2017) Diagnostic accuracy of the postoperative ratio of C-reactive protein to albumin for complications after colorectal surgery. World J Surg Oncol. 15(1):15CrossRef
18.
Zurück zum Zitat Asbury AK, Cornblath DR (1990) Assessment of current diagnostic criteria for Guillain-Barre syndrome. Ann Neurol 27(Suppl):S21–S24CrossRef Asbury AK, Cornblath DR (1990) Assessment of current diagnostic criteria for Guillain-Barre syndrome. Ann Neurol 27(Suppl):S21–S24CrossRef
19.
Zurück zum Zitat Wu X, Li C, Zhang B, Shen D, Li T, Liu K, Zhang HL (2015) Predictors for mechanical ventilation and short-term prognosis in patients with Guillain-Barre syndrome. Crit Care 19:310CrossRef Wu X, Li C, Zhang B, Shen D, Li T, Liu K, Zhang HL (2015) Predictors for mechanical ventilation and short-term prognosis in patients with Guillain-Barre syndrome. Crit Care 19:310CrossRef
20.
Zurück zum Zitat Hughes RA, Newsom-Davis JM, Perkin GD, Pierce JM (1978) Controlled trial prednisolone in acute polyneuropathy. Lancet. 2(8093):750–753CrossRef Hughes RA, Newsom-Davis JM, Perkin GD, Pierce JM (1978) Controlled trial prednisolone in acute polyneuropathy. Lancet. 2(8093):750–753CrossRef
21.
Zurück zum Zitat Teitelbaum JS, Borel CO (1994) Respiratory dysfunction in Guillain-Barre syndrome. Clin Chest Med 15(4):705–714CrossRef Teitelbaum JS, Borel CO (1994) Respiratory dysfunction in Guillain-Barre syndrome. Clin Chest Med 15(4):705–714CrossRef
22.
Zurück zum Zitat Wijdicks EF, Borel CO (1998) Respiratory management in acute neurologic illness. Neurology. 50(1):11–20CrossRef Wijdicks EF, Borel CO (1998) Respiratory management in acute neurologic illness. Neurology. 50(1):11–20CrossRef
23.
Zurück zum Zitat Szalai AJ (2004) C-reactive protein (CRP) and autoimmune disease: facts and conjectures. Clin Dev Immunol 11(3–4):221–226CrossRef Szalai AJ (2004) C-reactive protein (CRP) and autoimmune disease: facts and conjectures. Clin Dev Immunol 11(3–4):221–226CrossRef
24.
Zurück zum Zitat Mantovani A, Allavena P, Sica A, Balkwill F (2008) Cancer-related inflammation. Nature. 454(7203):436–444CrossRef Mantovani A, Allavena P, Sica A, Balkwill F (2008) Cancer-related inflammation. Nature. 454(7203):436–444CrossRef
25.
Zurück zum Zitat Sun F, Ge X, Liu Z, Du S, Ai S, Guan W (2017) Postoperative C-reactive protein/albumin ratio as a novel predictor for short-term complications following gastrectomy of gastric cancer. World J Surg Oncol 15(1):191CrossRef Sun F, Ge X, Liu Z, Du S, Ai S, Guan W (2017) Postoperative C-reactive protein/albumin ratio as a novel predictor for short-term complications following gastrectomy of gastric cancer. World J Surg Oncol 15(1):191CrossRef
26.
Zurück zum Zitat Tao C, Wang J, Hu X, Ma J, Li H, You C (2017) Clinical value of neutrophil to lymphocyte and platelet to lymphocyte ratio after aneurysmal subarachnoid hemorrhage. Neurocrit Care 26(3):393–401CrossRef Tao C, Wang J, Hu X, Ma J, Li H, You C (2017) Clinical value of neutrophil to lymphocyte and platelet to lymphocyte ratio after aneurysmal subarachnoid hemorrhage. Neurocrit Care 26(3):393–401CrossRef
Metadaten
Titel
Clinical value of C-reactive protein/albumin ratio in Guillain-Barré syndrome
verfasst von
Pingping Ning
Baiyuan Yang
Xinglong Yang
Hongyan Huang
Qiuyan Shen
Quanzhen Zhao
Haitao Lu
Li Yang
Sijia Tian
Yanming Xu
Publikationsdatum
27.11.2020
Verlag
Springer International Publishing
Erschienen in
Neurological Sciences / Ausgabe 8/2021
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-020-04930-4

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