Evidence map›Paper›PMID 33162744›Full record

ArticleAnnals of gastroenterology

The significance of C-reactive protein to albumin ratio in patients with decompensated cirrhosis.

Theodora Oikonomou, Ioannis Goulis, Stefania Kiapidou, Nikoletta Tagkou, Evangelos Akriviadis, George Papatheodoridis, Evangelos Cholongitas

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of gastroenterology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 17 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Theodora OikonomouFourth Department of Internal Medicine, Hippokration General Hospital, Medical School of Aristotle University of Thessaloniki (Theodora Oikonomou, Ioannis Goulis, Stefania Kiapidou, Evangelos Akriviadis).
Ioannis GoulisFourth Department of Internal Medicine, Hippokration General Hospital, Medical School of Aristotle University of Thessaloniki (Theodora Oikonomou, Ioannis Goulis, Stefania Kiapidou, Evangelos Akriviadis).
Stefania KiapidouFourth Department of Internal Medicine, Hippokration General Hospital, Medical School of Aristotle University of Thessaloniki (Theodora Oikonomou, Ioannis Goulis, Stefania Kiapidou, Evangelos Akriviadis).
Nikoletta TagkouFirst Department of Internal Medicine, Laiko General Hospital, Medical School of National and Kapodistrian University of Athens (Nikoletta Tagkou, George Papatheodoridis, Evangelos Cholongitas), Greece.
Evangelos AkriviadisFourth Department of Internal Medicine, Hippokration General Hospital, Medical School of Aristotle University of Thessaloniki (Theodora Oikonomou, Ioannis Goulis, Stefania Kiapidou, Evangelos Akriviadis).
George PapatheodoridisFirst Department of Internal Medicine, Laiko General Hospital, Medical School of National and Kapodistrian University of Athens (Nikoletta Tagkou, George Papatheodoridis, Evangelos Cholongitas), Greece.
Evangelos CholongitasFirst Department of Internal Medicine, Laiko General Hospital, Medical School of National and Kapodistrian University of Athens (Nikoletta Tagkou, George Papatheodoridis, Evangelos Cholongitas), Greece.
Laiko General Hospital of Athens · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrognostic indicators in patients with decompensated cirrhosis are vital for the estimation of death risk. The ratio of C-reactive protein to albumin (CAR) has been verified as a prognostic marker in patients with hepatocellular carcinoma and decompensated cirrhosis related to hepatitis B virus. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and gamma globulins have been separately studied in cirrhosis. We evaluated the predictive role of CAR and other inflammatory markers in decompensated patients.

methodsWe prospectively studied 159 patients with stable decompensated cirrhosis, calculating the following indexes: CAR, NLR, LMR, Child-Turcotte-Pugh (CTP), and model for end-stage liver disease (MELD).

resultsMELD (area under the curve [AUC] 0.814) and CTP score (AUC 0.752) were superior to the other markers above in predicting patients' mortality (P<0.05). Patients with CAR<2.17 (median value) presented better times of survival: 20 months (12-27) vs. 14 months (10-17) (log rank P=0.015). NLR and LMR barely discriminated patients' prognosis. In multivariate analysis, only MELD and CTP scores were significant risk factors, whether using the proposed cutoff of 1.3 (hazard ratio [HR] 1.17 [1.106-2.44], P<0.001) or the median 2.17 CAR categorical variable (HR 1.17 [1.104-1.243], P<0.001). When patients who underwent liver transplantation were excluded, apart from the MELD and CTP scores CAR 2.17 was the only significant factor associated with the outcome (HR 3.61 [0.96-13.6], P=0.05) and detected different survival times: 10 (1-48) vs. 11 (2-38) months, log rank P=0.003. Patients with LMR≥1.9 presented significantly better renal function, in terms of true glomerular filtration rate (80±34 vs. 64±33 mL/min, P=0.004) and creatinine levels: 0.84 (0.1-1.8) vs. 0.98 (0.59-3.3) mg/dL (P=0.001).

conclusionOur findings demonstrate the significance of CAR and LMR in the outcome and renal function of decompensated patients.

Indexed as

CRP-to-albumin ratiodecompensated cirrhosisgamma globulinslymphocyte-to-monocyte rationeutrophil-to-lymphocyte ratio

Identifiers

PMID33162744
PMCPMC7599343
OpenAlexW3088718750

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.