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Association between C-reactive protein/albumin ratio and mortality in older Japanese patients with post-stroke dysphagia

Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction The C-reactive protein/albumin ratio (CAR) could serve as an novel obtainable application for prognosis. Few studies have assessed CAR and mortality in older Japanese patients with post-stroke dysphagia (PSD). We evaluated CAR as a composite prognostic factor and compared its predictive performance with C-reactive protein (CRP) and albumin. Methods In this retrospective cohort study, 133 elderly Japanese patients with PSD (January 2014–January 2017) were analyzed. Cox proportional hazards models estimated associations of CAR, CRP, and albumin with mortality. Survival across CAR tertiles was compared by Kaplan–Meier curves. For 1-year mortality prediction we computed ROC curves and assessed incremental value using IDI and NRI. Results Among 133 patients (78 women, 55 men; mean age 80.5 years), each one-unit increase in CAR was associated with a 42% higher hazard of death in unadjusted analysis (HR 1.42; 95% CI 1.18–1.71; p < 0.001) and remained significant after full adjustment (HR 1.49; 95% CI 1.16–1.92; p = 0.002). Higher CAR tertiles had worse survival ( p < 0.0001). For 1-year mortality discrimination, CAR AUC = 0.702 (95% CI 0.606–0.798), albumin AUC = 0.710, CRP AUC = 0.685. Albumin improved prediction over CAR (IDI 0.108, p = 0.012; NRI 0.217, p = 0.044); CRP did not. Conclusion CAR was positively associated with mortality in older Japanese patients with PSD but had only modest discrimination for 1-year mortality. Albumin provided a small additional predictive benefit. Larger prospective studies are needed for validation.
Authors: Ziying Wang, Lingling Wang
Institution: Beihua University
Language: English
Subfield: Oncology
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W4416450078
FWCI: 1.117
Cites: 21
Cited by: 3
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