C-Reactive Protein to Albumin Ratio Predicts In-hospital Mortality in Patients with Acute Heart Failure.

OBJECTIVE: Acute heart failure remains at high risk of mortality despite recent advances in the management and treatment of heart failure. Recently, C-reactive protein to albumin ratio has been shown to predict all-cause mortality in heart failure with reduced ejection fraction. The association between C-reactive protein to albumin ratio and in-hospital mortality in patients with acute heart failure regardless of the left ventricular ejection fraction remains unknown. METHODS: In this retrospective, single-center cohort study, we included 374 hospitalized patients with acute decompensated heart failure. We calculated C-reactive protein to albumin ratio and evaluated the relationship between the values and in-hospital mortality. RESULTS: During hospitalization duration of 10 [6-17] days, need for hemodialysis/ultrafiltration, acute ischemic hepatitis, coagulopathy, ventricular tachycardia, invasive mechanical ventilation, and shock were more prevalent in the high C-reactive protein to albumin ratio (< 0.78) group compared to low C-reactive protein to albumin ratio ( ≥ 0.78) group. Mortality was higher in the high C-reactive protein to albumin ratio group in comparison to the low C-reactive protein to albumin ratio group (36.7% vs. 12%; P < 0.001). C-reactive protein to albumin ratio was independently and significantly associated with in-hospital mortality (hazard ratio = 1.69, 95% CI: 1.02-2.82; P = 0.042) by multivariate Cox proportional hazard analysis. In receiver operating characteristic analysis, C-reactive protein to albumin ratio was able to predict in-hospital mortality (area under the curve value for in-hospital mortality was 0.72; P < 0.001). CONCLUSION: Admission C-reactive protein to albumin ratio was associated with increased all-cause mortality in hospitalized patients with acute decompensated heart failure.

What are the factors that affect post COVID 1st month's continuing symptoms?

AIM: The aim of our research was to investigate retrospectively the relationship between the symptoms and general characteristics, initial laboratory values and treatments in patients who had COVID-19 and who applied to the chest diseases outpatient clinic for control after 1 month. METHOD: Three hundred fifteen patients who were diagnosed with COVID-19 and applied to the chest diseases outpatient clinic between May 2020 and August 2020 for control in the 1st month were included in the study. Patient information was collected from the hospital information system and the e-pulse system. RESULTS: Females accounted for 50.2% of our patients and their mean age was 47.9 ± 14.8 (19-88) years. About 14.3% (n: 45) of the individuals were 65 years of age and older, 20.6% (n: 65) of our patients were smoking and 70.2% (n: 221) of our patients were treated at home. A total of 133 patients had at least one comorbid disease. The patients most frequently reported cough, dyspnoea, weakness, myalgia and diarrhoea. The most common symptoms were cough, dyspnoea, weakness and myalgia in the 1st month. Initial D-dimer, initial CRP and the values of platelet, D dimer and CRP in the 1st month were detected to be higher in patients with persistent symptoms when the laboratory values of patients whose symptoms continue after 1 month were examined. It was determined that the symptoms had persisted in patients who had been hospitalised, had dual therapy, had comorbid diseases and had more common pathologies in their pulmonary imaging. CONCLUSION: Symptoms may persist for a long time in hospitalised patients, in patients with COVID-19-related pneumonia and concomitant chronic diseases and in patients with high D-dimer and high CRP at the time of admission. Patients are informed that their symptoms may last for a long time, unnecessary hospital admissions can be avoided.