Prognostic value of fibrinogen-to-albumin ratio in elderly patients with sepsis

WANG Tingting; SUN Yi; ZHAO Yanjun

doi:10.3969/j.issn.1002-7386.2025.07.007

Abstract：Objective To study the prognostic value of fibrinogen-to-albumin ratio(FAR)in elderly patients with sepsis.Methods A total of 125 elderly patients with sepsis admitted to the Emergency Department of Affiliated Hospital of Chengde Medical University from January 2021 to January 2023 were collected and grouped according to their 28-day outcomes.Patients with a self-determined discharge from ICU and died within 28 days were included in the poor prognosis group(n=50),and those with stable disease and transferred to the ward were included in the good prognosis group(n=75).Laboratory testing parameters within 24 hours,including white blood cell count(WBC),neutrophil count(Neu),lymphocyte count(Lym),monocyte count(Mon),lactic acid(Lac),red blood cell count(RBC),procalcitonin(PCT),C-reactive protein(CRP),albumin(ALB)and fibrinogen(Fib)were collected,and FAR was calculated according to the relevant test results.General data,including age,sex,underlying disease(diabetes,hypertension,coronary heart disease,cerebrovascular disease,chronic obstructive pulmonary disease),cause of death,length of stay and the Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ)score were recorded.Multivariate logistic regression analysis was performed by incorporating indicators with significant differences in the univariate analysis as variables,and the predictive value of risk factors in the prognosis of elderly sepsis patients was evaluated by drawing receiver operating characteristics(ROC)curves.Results In comparison to the good prognosis group,there were significantly larger proportion of male patients,higher CRP,FAR,Fib,Lac,and APACHE Ⅱ score,but lower Mon in the poor prognosis group(P＜0.05).Multivariate logistic regression analysis showed that FAR and Lac were independent risk factors for the poor prognosis in elderly sepsis patients(P＜0.05).ROC curve results showed that the area under the curve(AUC)of FAR was 0.702(0.610-0.785),which was higher than that of lactic acid 0.675(0.584-0.739).The optimal cut-off value of FAR determined by the Youden index was 21.14,with a specificity of 84.0％,and a sensitivity of 52.0％.Survival analysis was conducted according to the optimal cut-off value.The survival rate of the high-level FAR group was significantly lower than that of the low-level FAR group(log-rank x2=16.044,P＜0.000).The survival rate of the high-level lactic acid group was significantly lower than that of the low-level lactic acid group(log-rank x2=19.260,P＜0.000).Conclusion In elderly patients with sepsis,FAR and lactic acid both have significant predictive value for their prognosis.When the FAR＞21.140,the survival of elderly patients with sepsis significantly decreased.The predictive value of FAR is superior to the lactic acid.