C-reactive protein-to-albumin ratio as a predictor of 28-day mortality in critically ill pediatric patients: a retrospective cohort study Article Swipe
Jie Chang
,
Xiaojuan Zhang
,
Weimin Wang
,
Liping Liu
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1186/s12887-025-06261-9
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1186/s12887-025-06261-9
Objective This large-scale real-world study aimed to evaluate whether the C-reactive protein-to-albumin ratio (CAR), an indicator of systemic inflammation and nutritional status, predicts 28-day mortality in critically ill pediatric patients. Design Retrospective cohort study. Methods We analyzed data from 8,000 children admitted to a tertiary pediatric intensive care unit (PICU) in China between 2010 and 2019. CAR was calculated using initial CRP and albumin levels upon admission. Patients were stratified into quartiles based on CAR values. The primary outcome was 28-day all-cause mortality; in-hospital mortality was a secondary outcome. Multivariable Cox regression and Kaplan–Meier survival analyses were performed, along with subgroup analyses to validate robustness. Results Higher CAR levels were significantly associated with increased 28-day mortality. Patients in the highest CAR quartile had a hazard ratio of 1.51 (95% CI: 1.07–2.13; p = 0.018) compared with the lowest quartile. The fully adjusted model including CAR achieved an AUC of 0.820 (95% CI: 0.798–0.843), indicating good discriminatory ability. Kaplan-Meier curves confirmed reduced survival in the high CAR group (p = 0.0042). The association remained consistent across all subgroups. Conclusion CAR is significantly associated with short-term mortality in critically ill children. As a low-cost, easily accessible biomarker, CAR may serve as a valuable early risk stratification tool in real-world pediatric intensive care settings.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1186/s12887-025-06261-9
- OA Status
- gold
- References
- 40
- OpenAlex ID
- https://openalex.org/W4415648878
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https://openalex.org/W4415648878Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1186/s12887-025-06261-9Digital Object Identifier
- Title
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C-reactive protein-to-albumin ratio as a predictor of 28-day mortality in critically ill pediatric patients: a retrospective cohort studyWork title
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articleOpenAlex work type
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-10-27Full publication date if available
- Authors
-
Jie Chang, Xiaojuan Zhang, Weimin Wang, Liping LiuList of authors in order
- Landing page
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https://doi.org/10.1186/s12887-025-06261-9Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1186/s12887-025-06261-9Direct OA link when available
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0Total citation count in OpenAlex
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40Number of works referenced by this work
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| abstract_inverted_index.0.798–0.843), | 153 |
| abstract_inverted_index.protein-to-albumin | 12 |
| cited_by_percentile_year | |
| countries_distinct_count | 1 |
| institutions_distinct_count | 4 |
| citation_normalized_percentile |