Avaliação do rácio proteína c-reativa/albumina como preditor de mortalidade em emergências gastrointestinais na espécie canina
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2024
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As emergências gastrointestinais são comuns em medicina veterinária, mas os biomarcadores prognósticos validados para a mortalidade a curto prazo nestas patologias continuam limitados. Este estudo teve como objetivo avaliar o valor preditivo do rácio proteína C-reativa (PCR)/albumina (ALB) como um preditor de prognóstico em cães com emergências gastrointestinais, médicas ou cirúrgicas. Também se procurou avaliar o valor preditivo da PCR e ALB individualmente. Neste estudo foram incluídos os dados de 26 cães admitidos em três centros de atendimento médico veterinários com emergências gastrointestinais, médicas ou cirúrgicas. No total foram recolhidas e analisadas 26 amostras de sangue na admissão e 26 antes do desfecho clínico, perfazendo um total de 52 amostras de sangue. Na análise estatística, foram comparadas as diferenças e correlações observadas entre os valores da PCR, ALB, e do rácio PCR/ALB entre o grupo de animais que receberam alta e o grupo de animais que morreram, através do teste t Student ou teste de Mann-Whitney e teste de correlação de Pearson ou de Spearman, conforme apropriado. A capacidade preditiva destes biomarcadores para a mortalidade foi também avaliada através da uma análise ROC e da regressão logística binária. A PCR e o rácio PCR/ALB apresentaram valores significativamente mais elevados nos cães que morreram, enquanto a ALB isoladamente não apresentou o mesmo padrão. A PCR e o rácio PCR/ALB apresentaram uma boa correlação. Na análise ROC, a PCR e o rácio PCR/ALB mostraram uma forte capacidade preditiva de morte neste tipo de pacientes. Em contraste, a ALB isoladamente não foi preditiva de mortalidade. Estes resultados foram confirmados na análise de regressão logística binária, na qual a PCR e o rácio PCR/ALB também mostraram estar associados ao aumento da probabilidade de morte. Este estudo demonstrou que tanto o rácio PCR/ALB como a PCR são preditores eficazes de mortalidade em cães com emergências gastrointestinais. Adicionalmente, foi demonstrado que valores de PCR superiores a 5,76 mg/dl e um rácio PCR/ALB superior a 3, são valores de corte associados a um aumento do risco de morte neste tipo de emergências. Palavras-chave: cães, proteína C reativa, albumina, rácio proteína C reativa/albumina, emergências gastrointestinais, mortalidade
Gastrointestinal emergencies are common in veterinary medicine, but validated prognostic biomarkers for short-term mortality in these conditions remain limited. This study aimed to evaluate the predictive value of the C-reactive protein (CRP)/albumin (ALB) ratio as an outcome predictor in dogs with gastrointestinal emergencies, either medical or surgical. It also sought to assess the predictive value of CRP and ALB individually. This study included data from 26 dogs admitted to three veterinary care centers with medical or surgical gastrointestinal emergencies. A total of 26 blood samples were collected and analyzed at admission and 26 before the clinical outcome, totaling 52 blood samples. In the statistical analysis, differences and correlations observed between CRP, ALB, and the CRP/ALB ratio values were compared between the group of animals discharged and the group of animals that died, using the Student’s t-test or the Mann-Whitney test and Pearson or Spearman correlation tests, as appropriate. The predictive ability of these biomarkers for mortality was also evaluated using ROC analysis and binary logistic regression. CRP and the CRP/ALB ratio showed significantly higher values in dogs that died, while ALB alone did not show the same pattern. CRP and the CRP/ALB ratio showed a good correlation. In the ROC analysis, CRP and the CRP/ALB ratio demonstrated strong predictive ability for death in these patients. In contrast, ALB alone was not predictive of mortality. These results were confirmed in the binary logistic regression analysis, where CRP and the CRP/ALB ratio were also associated with an increased probability of death. This study demonstrated that both the CRP/ALB ratio and CRP are effective predictors of mortality in dogs with gastrointestinal emergencies. Additionally, it was shown that CRP values above 5.76 mg/dL and a CRP/ALB ratio above 3 are cut-off values associated with an increased risk of death in these types of emergencies. Keywords: dogs, C reactive protein, albumin, C reactive protein/albumin ratio, gastrointestinal emergencies, mortality
Gastrointestinal emergencies are common in veterinary medicine, but validated prognostic biomarkers for short-term mortality in these conditions remain limited. This study aimed to evaluate the predictive value of the C-reactive protein (CRP)/albumin (ALB) ratio as an outcome predictor in dogs with gastrointestinal emergencies, either medical or surgical. It also sought to assess the predictive value of CRP and ALB individually. This study included data from 26 dogs admitted to three veterinary care centers with medical or surgical gastrointestinal emergencies. A total of 26 blood samples were collected and analyzed at admission and 26 before the clinical outcome, totaling 52 blood samples. In the statistical analysis, differences and correlations observed between CRP, ALB, and the CRP/ALB ratio values were compared between the group of animals discharged and the group of animals that died, using the Student’s t-test or the Mann-Whitney test and Pearson or Spearman correlation tests, as appropriate. The predictive ability of these biomarkers for mortality was also evaluated using ROC analysis and binary logistic regression. CRP and the CRP/ALB ratio showed significantly higher values in dogs that died, while ALB alone did not show the same pattern. CRP and the CRP/ALB ratio showed a good correlation. In the ROC analysis, CRP and the CRP/ALB ratio demonstrated strong predictive ability for death in these patients. In contrast, ALB alone was not predictive of mortality. These results were confirmed in the binary logistic regression analysis, where CRP and the CRP/ALB ratio were also associated with an increased probability of death. This study demonstrated that both the CRP/ALB ratio and CRP are effective predictors of mortality in dogs with gastrointestinal emergencies. Additionally, it was shown that CRP values above 5.76 mg/dL and a CRP/ALB ratio above 3 are cut-off values associated with an increased risk of death in these types of emergencies. Keywords: dogs, C reactive protein, albumin, C reactive protein/albumin ratio, gastrointestinal emergencies, mortality
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VETERINARY MEDICINE, CANIDS, C-REACTIVE PROTEIN, DIGESTIVE SYSTEM DISEASES, MORALITY, BIOMARKERS, MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, MEDICINA VETERINÁRIA, VETERINÁRIA, CANÍDEOS, PROTEÍNA C-REATIVA, ALBUMINAS, DOENÇAS DO SISTEMA DIGESTIVO, MORTALIDADE, BIOMARCADORES, Mestrado Integrado em Medicina Veterinária