ArticleFrontiers in neurology
C-reactive protein to albumin ratio as a novel predictor of stroke-associated pneumonia: a retrospective cohort study revealing non-linear threshold effects.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Incremental Prognostic Value of the C-Reactive Protein-to-Albumin Ratio Beyond a Parsimonious Clinical Reference Model in Critically Ill Patients with Acute Ischemic Stroke.Diagnostics (Basel, Switzerland) · 2026Article
- Prognostic value of C-reactive protein to albumin ratio for in-hospital mortality in acute stroke patients.BMC neurology · 2026Article
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5 authors.
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Abstract
Background: Stroke-associated pneumonia (SAP) complicates 10-30% of acute ischemic stroke (AIS) cases and worsens outcomes. The C-reactive protein to albumin ratio (CAR) integrates inflammation and nutritional status and may serve as a prognostic biomarker. However, non-linear relationships and threshold effects for CAR in SAP prediction remain unclear. Methods: We retrospectively analyzed 1,595 consecutive AIS patients admitted between September 2016 and September 2022. CAR was calculated from admission CRP and albumin. Associations between CAR and SAP were assessed using multivariable logistic regression, generalized additive models (GAM), and two-piecewise regression to identify thresholds. Predictive performance was evaluated by ROC analysis and DeLong's test. Results: A total of 1,595 patients were included (58.6% male; mean age 70.1 ± 12.2 years). The median admission NIHSS score was 3.0 (IQR 1.0-6.0). SAP occurred in 376 patients (23.6%). Log₂-CAR was strongly associated with SAP risk (P-trend < 0.0001), with the highest quartile showing a fully adjusted OR of 6.11 (95% CI: 3.63-10.27, Conclusion: CAR is a strong and independent predictor of stroke-associated pneumonia, outperforming traditional markers and improving risk prediction in acute stroke patients.
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