The Procalcitonin Combined with C-Reactive Protein/Albumin Ratio as a Predictor of Mortality in Patients After Lung Transplantation

Background The Procalcitonin (PCT) and C-reactive protein (CRP)/albumin ratio have recently been used to predict early prognosis for intensive care unit (ICU) patients and patients undergoing major surgery. But there were few clinical studies in patients after lung transplantation (LTX). Aim/Purpose The purpose of this study was to identify the association between PCT combined with CRP/albumin ratio and 30-day mortality and predict the accuracy of PCT combined with CRP/albumin ratio for 30-day mortality in patients after LTX. Method From January 1, 2016 to December 1, 2020, the clinical data of 77 patients undergoing LTX who died within 30 days were retrospectively collected, we randomly collected 87 patients survived more than 30 days after LTX. ROC curve was used to evaluate the prognostic value of PCT combined with CRP/albumin in predicting mortality at 30 days after ICU admission, Cox proportional hazard model analysis was used to identify risk factors, subgroup analyses was conducted. Results Postoperative PCT, CRP, albumin, CRP/albumin ratio, atrial fibrillation, primary graft dysfunction (PGD) grade, the hours of postoperative mechanical ventilation (MV) and length of ICU stay between survivor and non-survivor had a significant difference . On Cox proportional hazard regression analysis, both PCT [HR 1.02 (1.00–1.05), P = 0.037] and CRP/albumin ratio [HR 1.438 (1.26–1.65), P < 0.001] were independent predictors of 30-day mortality. In all patients after LTX, the area under the curve (AUC) of PCT combined with CRP/albumin ratio for predicting 30-day mortality was 0.76 (95% CI 0.69–0.83). In subgroup analysis, the AUC of PCT combined with CRP/albumin ratio for predicting 30-day mortality was 0.83 (95% CI 0.75–0.91) in patients undergoing LTX for interstitial pulmonary fibrosis (IPF). Conclusion The PCT combined with CRP/albumin ratio could be a predictor of the outcomes in patients undergoing LTX. The predictive efficacy was better in patients undergoing LTX for IPF.