Fibrinogen-to-Albumin Ratio in Neonatal Sepsis

Figures & data

Table 1 Basic Characteristics of Study Subjects

Variables	Control (n= 555)	Sepsis (n = 737)	Sepsis
			Mild Sepsis (n=312)	Severe Sepsis (n=425)
Age (days)	7.0 (4.0, 12.0)	10.0 (5.0, 17.0)^a	11.0 (5.0, 18.0)^b	10.0 (5.0, 16.0)^c
Male, n (%)	318 (57.3%)	453 (61.5%)	194 (62.2%)	259 (60.9%)
Body Weight (kg)	3.30±0.52	3.21±0.63^a	3.34±0.55^b	3.12±0.68^cd
Temperature (°C)	36.9±0.4	37.4±0.8^a	37.4±0.7^b	37.3±0.8^c
Respiratory rate (rate/minute)	46.3 ±7.6	49.8±10.9^a	49.2±10.2^b	50.2±11.5^c
Heart rate (bpm)	142.4 ± 15.7	149.7 ± 19.6^a	148.0 ± 18.6^b	151.0 ± 20.1^c
Biochemical parameters
PCT (ng/mL)	0.73 (0.10, 0.25)	5.60 (0.14, 1.52)^a	2.63 (0.11, 0.77)^b	7.78 (0.16, 2.21)^cd
CRP (mg/L)	0.7 (0.7, 0.7)	0.7 (0.7, 13.48)^a	0.7 (0.7, 8.25)^b	0.7 (0.7, 17.31)^c
FIB (g/L)	2.06 (1.69, 2.48)	2.42 (1.77, 3.14)^a	2.44 (1.84, 3.13)^b	2.39 (1.68, 3.18)^c
TBIL (μmol/L)	298.2 (230.9, 355.8)	132.0 (45.4, 216.1)^a	158.5 (47.2, 228.9)^b	144.1 (43.9, 208.1)^c
ALT (U/L)	25.5 (20.0, 33.2)	28.5 (21.8, 37.9)^a	31.93 (22.2, 36.1)^b	49.71 (21.4, 39.9)^cd
AST (U/L)	37.9 (30.2, 51.0)	38.5 (27.9, 55.2)^a	45.7 (27.9, 49.5)^b	100.4 (28.0, 63.0)^cd
TP (g/L)	57.3 ± 6.7	54.1 ± 7.4^a	54.78 ± 6.62^b	53.62 ± 7.89^cd
ALB (g/L)	33.8 ± 4.0	30.6 ± 4.9^a	31.44 ± 4.65^b	29.95 ± 5.00^cd
UREA (mmol/L)	2.3 (1.5, 3.2)	3.1 (1.9, 4.4)^a	3.2 (1.9, 4.0)^b	4.3 (2.0, 5.0)^cd
CREA (μmol/L)	51.0 (42.0, 59.3)	47.3 (37.4, 63.2)	48.48 (35.83, 55.68)^b	65.50 (38.70, 68.75)^cd
UA (μmol/L)	137.9 (103.1, 182.5)	149.1 (110.2, 205.5)^a	165.9 (108.1, 191.6)	201.3 (111.1, 219.8)^cd
FAR (*10^−3)	60.80 (49.58, 75.95)	79.61 (56.14, 106.84)^a	78.32 (57.32, 103.97)^b	80.40 (54.01, 109.09)^c

Notes: All values are presented as the mean ± SD or n (%) or as the median (interquartile range). ^aP < 0.05 for sepsis vs control. ^bP < 0.05 for mild sepsis vs control. ^cp < 0.05 for severe sepsis vs control. ^dP < 0.05 for severe sepsis vs mild sepsis.

Abbreviations: FAR, fibrinogen-to-albumin ratio. PCT, procalcitonin. CRP, C-reactive protein. FIB, fibrinogen. TBIL, total bilirubin. ALT, alanine aminotransferase. AST, aspartate aminotransferase. TP, total protein. ALB, albumin. UREA, urea nitrogen. CREA, creatinine. UA, uric acid.

Table 2 The Presence and Severity of Neonatal Sepsis According to FAR Tertiles

Variables	Tertile 1 (<57.06) (n = 431)	Tertile 2 (57.06–83.98) (n = 432)	Tertile 3 (>83.98) (n = 429)	P
Age (days)	9.0 (5.0, 12.0)	10.4 (4.0, 16.0)^a	11.4 (5.0, 16.0)^b	< 0.001
Male, n (%)	264 (61.3%)	246 (56.9%)	261 (60.8%)	0.363
Overall sepsis	199 (53.20%)	210 (58.2%)	328 (88.5%)^bc	< 0.001
Control, n (%)	232 (41.8%)	222 (40.0%)	101 (18.2%)^bc	< 0.001
Mild sepsis, n (%)	75 (24.0%)	104 (33.3%)^a	133 (42.6%)^bc	< 0.001
Severe sepsis, n (%)	124 (29.2%)	106 (24.9%)	195 (45.9%)^bc	< 0.001

Notes: FAR, fibrinogen-to-albumin ratio. ^aP < 0.05 for Tertile 2 vs Tertile 1, ^bP < 0.05 for Tertile 3 vs Tertile 1, ^cP < 0.05 for Tertile 3 vs Tertile 2.

Table 3 Correlations Between FAR and Clinical Parameters

Variables	Overall Population		Neonates with Sepsis
	r	P	r	P
Age	0.160	< 0.001	− 0.025	0.491
Weight	− 0.086	0.002	0.119	0.001
Temperature	0.229	< 0.001	− 0.004	0.906
Respiratory	0.174	< 0.001	0.066	0.074
Heart rate	0.218	< 0.001	0.069	0.062
PCT	0.283	< 0.001	0.109	0.003
CRP	0.257	< 0.001	0.039	0.289
ALT	0.106	0.680	−0.015	0.689
AST	0.025	0.376	0.048	0.194
TP	−0.111	< 0.001	0.018	0.633
Length of hospital stay	0.375	< 0.001	0.103	0.005

Abbreviations: FAR, fibrinogen-to-albumin ratio. PCT, procalcitonin. CRP, C-reactive protein. ALT, alanine aminotransferase. AST, aspartate aminotransferase. TP, total protein.

Table 4 Regression Analysis to Assess the Presence of Neonatal Sepsis and Severe Sepsis According to FAR Tertiles

Variables	Univariate		Multivariate*
	OR (95% CI)	P	OR (95% CI)	P
Presence of overall sepsis
FAR	8.641 (5.708–13.080)	< 0.001	2.817 (1.701–4.666)	< 0.001
FAR tertiles
Tertile 1	1		1
Tertile 2	1.119 (0.856, 1.462)	0.411	0.980 (0.722, 1.330)	0.898
Tertile 3	3.768 (2.813, 5.046)	< 0.001	1.819 (1.280, 2.586)	0.001
Presence of severe sepsis
FAR	2.853 (2.040–3.988)	< 0.001	1.670 (1.098–2.538)	0.016
FAR tertiles
Tertile 1	1		1
Tertile 2	0.822 (0.607, 1.112)	0.203	0.800 (0.573, 1.117)	0.189
Tertile 3	2.071 (1.561, 2.747)	< 0.001	1.498 (1.067, 2.105)	0.020

Note: *Adjusted for age, temperature, respiratory rate, weight, PCT, CRP, ALT, TP.

Abbreviations: FAR, fibrinogen-to-albumin ratio; PCT, procalcitonin; CRP, C-reactive protein; ALT, alanine aminotransferase; TP, total protein.