Evaluation of C - reactive Protein, Albumin and the C - reactive Protein/Albumin Ratio as Prognostic Markers in Trauma Patients Admitted to Intensive Care Unit

Background and Objectives: Deaths, injuries and disabilities resulting from Road traffic injuries (RTIs) are considered as the major concerns in public health and they are the second highest cause of mortality in Iran. Traumatic injury accounts for approximately one of six hospital admissions and almost 20% of the cases include admission to intensive care units (ICU). Laboratory diagnostic tests can help predict the clinical outcome of these patients. This study aimed to determine the ability of C-reactive protein (CRP), albumin and the CRP/albumin ratio to predict the outcome of trauma patients admitted to ICU.

Methods: We evaluated 76 patients with traumatic injury admitted to ICU for more than 48 h. CRP, albumin and the CRP/albumin ratio were measured on day one and three after admission to ICU and analysed with regard to predictability of mortality and survival.

Results: There was a significant association between CRP, albumin and the CRP/albumin ratio on the first and the third day upon admission (t-test, p=0.03). The mortality rate was correlated with an increase in the CRP/albumin ratio, and patients with a ratio of 4.01–9 had a poorer clinical outcome in comparison with other patients. High mortality and a poor outcome were seen in patients with a CRP concentration more than 12 mg/dl and an albumin level less than 3 g/dl in our study.

Conclusion: Albumin, CRP and the CRP/albumin ratio are simple and reliable prognostic markers in ICU patients with traumatic injury.