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Clinical value of C-reactive protein/albumin ratio in Guillain-Barré syndrome

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Abstract

Background

Respiratory failure in patients with Guillain-Barré syndrome (GBS) can lead to serious complications and dysfunctions, emphasizing the importance of early detection. The C-reactive protein-to-albumin ratio (CAR) is emerging as a novel inflammatory marker for predicting neurological outcome. We aimed to identify the association of CAR with respiratory failure and short-term outcome in GBS patients.

Methods

A total of 200 patients diagnosed with GBS were retrospectively analyzed. Data were collected from an electronic database. The associations of C-reactive protein (CRP), albumin, and CAR at admission with outcomes were evaluated by logistic regression analysis. Using receiver operating characteristic curves, we calculated the cutoff value for the CAR and compared its discriminatory power with that of C-reactive protein alone.

Results

Fifty-two (26%) patients showed poor short-term outcome, and 50 (25%) developed respiratory failure. CAR > 0.21 was an independent predictor of respiratory failure, and CAR > 0.19 was an independent predictor of poor short-term outcome. CAR showed a better predictive value than CRP alone. In addition, the c-index of the predictive nomogram for respiratory failure was higher when it included CAR (0.962) than when it did not (0.958). A similar result was observed for the predictive nomogram for poor short-term outcome (0.953 vs 0.947).

Conclusion

CAR > 0.21, a novel inflammatory biomarker, is independently associated with the occurrence of respiratory failure in GBS patients, while CAR > 0.19 is independently associated with poor short-term outcome. CAR may help identify GBS patients at high risk of poor prognosis.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgments

We thank the Guillain-Barré syndrome patients for their participation in our study.

Funding

This work was supported by the Basic Conditions Platform Construction Project of Sichuan Science and Technology Department (2019JDPT0015), the “1・3・5 project for disciplines of excellence, West China Hospital, Sichuan University” (ZYJC18003), and the Yunnan Applied Basic Research Project (2019FE001(-048)).

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Authors and Affiliations

  1. Department of Neurology, West China Hospital, Sichuan University, 37, Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China

    Pingping Ning, Hongyan Huang, Qiuyan Shen, Quanzhen Zhao, Haitao Lu, Li Yang, Sijia Tian & Yanming Xu

  2. Department of Neurology, Chengdu Seventh People’s Hospital, 1188 Shuangxing Avenue, Shuangliu District, Chengdu, 610213, Sichuan Province, China

    Baiyuan Yang

  3. Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, 295, Xi Change Road, Kunming, 650032, Yunnan Province, China

    Xinglong Yang

Authors
  1. Pingping Ning
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  2. Baiyuan Yang
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  3. Xinglong Yang
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  4. Hongyan Huang
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  5. Qiuyan Shen
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  6. Quanzhen Zhao
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  7. Haitao Lu
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  8. Li Yang
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  9. Sijia Tian
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  10. Yanming Xu
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Contributions

Conceptualization: Pingping Ning, Baiyuan Yang, Xinglong Yang, Yanming Xu; Methodology: Pingping Ning, Baiyuan Yang, Xinglong Yang; Formal analysis and investigation: Hongyan Huang, Qiuyan Shen, Quanzhen Zhao, Haitao Lu, Li Yang, Sijia Tian; Writing—original draft preparation: Pingping Ning; Writing—review and editing: Baiyuan Yang, Yanming Xu; Supervision: Yanming Xu

Corresponding author

Correspondence to Yanming Xu.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethics Committee of West China Hospital, Sichuan University.

Consent to participate

Written informed consent was obtained from all patients for their anonymized clinical data to be published for research purposes.

Consent for publication

Written informed consent was obtained from all patients for their anonymized clinical data to be published for research purposes.

Code availability

The code used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Heading

1. A ratio of C-reactive protein-to-albumin > 0.21, a novel inflammatory biomarker, is independently associated with the occurrence of respiratory failure in GBS patients.

2. A ratio of C-reactive protein-to-albumin > 0.19 is independently associated with poor short-term outcome in GBS patients.

3. The ratio of C-reactive protein-to-albumin predicts prognosis better than C-reactive protein alone.

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Cite this article

Ning, P., Yang, B., Yang, X. et al. Clinical value of C-reactive protein/albumin ratio in Guillain-Barré syndrome. Neurol Sci 42, 3275–3283 (2021). https://doi.org/10.1007/s10072-020-04930-4

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  • DOI: https://doi.org/10.1007/s10072-020-04930-4

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