Application value of the albumin-to-globulin ratio in patients with wasp stings: A retrospective cohort study.

ObjectiveTo evaluate the clinical utility of the admission albumin-to-globulin ratio for assessing disease severity and predicting prognosis in patients with wasp stings.MethodsThis retrospective cohort study enrolled 161 hospitalized patients categorized into mild, moderate, and severe groups according to the 2018 Chinese Expert Consensus Criteria. Baseline characteristics, admission albumin-to-globulin ratio, and inflammatory markers were compared among the severity groups. Spearman correlation analysis was used to assess associations between the albumin-to-globulin ratio and clinical parameters. Multivariable logistic regression was performed to identify independent risk factors for poor prognosis, multiple organ dysfunction syndrome, and acute kidney injury. Receiver operating characteristic curve analysis was used to evaluate the predictive performance of admission albumin-to-globulin ratio and its coefficient of variation.ResultsAdmission albumin-to-globulin ratio was significantly lower in the severe group (p < 0.05) and negatively correlated with white blood cell count, C-reactive protein, procalcitonin, and serum amyloid A. Decreased albumin-to-globulin ratio and elevated coefficient of variation of the albumin-to-globulin ratio were independent risk factors for multiple organ dysfunction syndrome and acute kidney injury. Admission albumin-to-globulin ratio demonstrated strong diagnostic efficacy, with areas under the curve of 0.822 for multiple organ dysfunction syndrome and 0.860 for acute kidney injury. The combination of albumin-to-globulin ratio with coefficient of variation of the albumin-to-globulin ratio significantly improved the areas under the curve for multiple organ dysfunction syndrome prediction to 0.934 (95% confidence interval: 0.854-0.978), yielding 89.29% sensitivity and 82.00% specificity. Admission albumin-to-globulin ratio provides early risk stratification tool, whereas coefficient of variation of the albumin-to-globulin ratio reflects dynamic changes during hospitalization and provides complementary prognostic information. Furthermore, patients with an admission albumin-to-globulin ratio ≤1.1 exhibited significantly higher incidences of acute kidney injury, multiple organ dysfunction syndrome, hepatic dysfunction, and coagulopathy (p < 0.001).ConclusionsAdmission albumin-to-globulin ratio is a simple, effective biomarker for risk stratification in patients with wasp sting. Integrating static admission albumin-to-globulin ratio with dynamic coefficient of variation of the albumin-to-globulin ratio enhances predictive accuracy and may support incorporation of these measures into routine clinical protocols to facilitate early identification of high-risk individuals and guide intensive interventions.