Predictive value of d-dimer/albumin ratio and fibrinogen/albumin ratio for in-hospital mortality in patients with COVID-19
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