ArticleBMC pediatrics2025
C-reactive protein-to-albumin ratio as a predictor of 28-day mortality in critically ill pediatric patients: a retrospective cohort study.
Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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Who cites it
3 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
- The predictive value of the ratio of multi-dimensional inflammatory biomarkers in pediatric diseases from the perspective of pro-inflammatory/anti-inflammatory balance: a systematic review.Translational pediatrics · 2026Review
- CRP-To-Albumin Ratio and CALLY Index for Sepsis Identification and Mortality Discrimination in Critically Ill Children.Pediatrics international : official journal of the Japan Pediatric SocietyArticle
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis 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.
designRetrospective cohort study.
methodsWe 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.
resultsHigher 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.
conclusionCAR 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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