PCT-to-albumin ratio and CRP-to-albumin ratio as predictors of febrile neutropenia complications: a prospective observational trial.

PURPOSE: This study aimed to determine whether procalcitonin-to-albumin ratio (PAR) and C-reactive protein-to-albumin ratio (CAR) can be alternatives to the Multinational Association for Supportive Care in Cancer (MASCC) risk index score in predicting bacteriemia, septicemia, death during FN, and 28-day mortality, in patients with febrile neutropenia (FN).

METHODS

This is a prospective observational study that included 185 participants with FN. Clinical and laboratory findings like PAR and CAR were analyzed, and their ability to predict FN complications was investigated.

RESULTS

From the included population, the 91 subjects (49.46%) had low-risk FN with MASCC risk index ≥ 21. Sixteen participants (8.70%) had bacteremia, and eight developed septicemia (4.89%). Before resolving FN, 15 people died, and in total 33 died within 28 days of diagnosis. The ROC curve analysis indicates that the CAR (p = 0.0008921) better predicts mortality during FN, and the PAR (p = 0.0003535) better predicts bacteremia. Incorporating CAR values into the MASCC risk index predicts mortality by as much as 33.33% more precisely than the MASCC risk index alone. The CAR values > 2.74 were an independent predictor of 28-day mortality (OR = 3.70; 95% CI = 1.08-13.02; p = 0.0376).

CONCLUSION

The study results suggest that PAR and CAR can be leveraged as valuable prognostic tools in predicting bacteremia, septicemia, mortality during FN, and 28-day mortality in patients with FN.