Combining C-reactive protein, procalcitonin, and serum albumin to predict long-term mortality in patients with infective endocarditis

Abstract

Objective To determine the predictive value of C-reactive protein (CRP) plus albumin plus procalcitonin for long-term mortality in patients with infective endocarditis. Methods This retrospective study included patients hospitalized with infective endocarditis between February 2008 and December 2021. CRP, procalcitonin, and albumin levels were measured within 24 h of admission and dichotomized as high or low. A CRP plus procalcitonin plus albumin points system (range, 3–6) was generated based on high or low CRP, procalcitonin, and albumin concentrations. Patients were divided into two groups: low-risk (≤4 points) and high-risk (>4 points), according to total score. The primary outcome was defined as all-cause mortality rate at long-term follow-up. Results Out of 204 patients in total, the high-risk group ( n = 29) had higher procalcitonin and CRP levels versus the low-risk group ( n = 175), but lower albumin level versus the low-risk group (2.7 ± 0.5 versus 3.5 ± 0.6 g/dl). Matching based on propensity scores showed a higher mortality rate in high-risk versus low-risk patients (76% versus 44%, respectively). In multivariate analysis after matching, the high-risk group was associated with increased long-term mortality (adjusted hazard ratio 2.87, 95% confidence interval 1.32, 6.26). Conclusions: A high CRP plus albumin plus procalcitonin score was associated with long-term mortality risk in patients with infective endocarditis.