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Predictive value of d-dimer/albumin ratio and fibrinogen/albumin ratio  for in-hospital mortality in patients with COVID-19            
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  • Kadir Küçükceran,
  • Mustafa Kürşat Ayrancı,
  • Sadik Girisgin,
  • Sedat Koçak
Kadir Küçükceran
Necmettin Erbakan University Meram Medical Faculty Hospital
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Mustafa Kürşat Ayrancı
Necmettin Erbakan University Meram Medical Faculty Hospital
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Sadik Girisgin
Necmettin Erbakan University Meram Medical Faculty Hospital
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Sedat Koçak
Necmettin Erbakan University Meram Medical Faculty Hospital
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Abstract

Introduction: Due to the high mortality of coronavirus disease 2019 (COVID-19), there are difficulties in the managing emergency department. We investigated whether the d-dimer/albumin ratio (DAR) and fibrinogen/albumin ratio (FAR) predicts mortality in the COVID-19 patients.
Methods: A total of 717 COVID-19 patients who were brought to the emergency department from March to October 2020 were included in the study. Levels of d-dimer, fibrinogen, and albumin, as well as DAR, FAR, age, gender, and in-hospital mortality status of the patients were recorded. The patients were grouped by in-hospital mortality. Statistical comparison was conducted between the groups.
Results: Of the patients included in the study, 371(51.7%) were male, and their median age was 64 years (50–74). There was in-hospital mortality in 126 (17.6%) patients. The area-under-the-curve (AUC) and odds ratio values obtained by DAR to predict in-hospital mortality were higher than the values obtained by the all other parameters (AUC of DAR, albumin, d-dimer, FAR, and fibrinogen: 0.773, 0.766, 0.757, 0.703, and 0.637, respectively; odds ratio of DAR>56.36, albumin<4.015, d-dimer>292.5, FAR>112.33, and fibrinogen>423: 7.898, 6.216, 6.058, 4.437, and 2.794, respectively). In addition; patients with concurrent DAR>56.36 and FAR>112.33 had an odds ratio of 21.879 with respect to patients with concurrent DAR<56.36 and FAR<112.33.
Conclusion: DAR may be used as a new marker to predict mortality in COVID-19 patients. In addition the concurrent high DARs and FARs were found to be more valuable in predicting in-hospital mortality than either separately.
Keywords: Covid-19, D-dimer, Fibrinogen, Serum Albumin, in-Hospital Mortality

Peer review status:ACCEPTED

17 Mar 2021Submitted to International Journal of Clinical Practice
18 Mar 2021Submission Checks Completed
18 Mar 2021Assigned to Editor
18 Mar 2021Reviewer(s) Assigned
19 Mar 2021Review(s) Completed, Editorial Evaluation Pending
31 Mar 20211st Revision Received
02 Apr 2021Submission Checks Completed
02 Apr 2021Assigned to Editor
04 Apr 2021Reviewer(s) Assigned
05 Apr 2021Review(s) Completed, Editorial Evaluation Pending
06 Apr 2021Editorial Decision: Accept