Giriş ve Amaç: Bu çalışmada yeni tanı siroz Hastalarında tanı anindakiC-reaktif protein-albümin oraninin hepatosellüler karsinom, hepatik ensefalopati, mortalite, Child-Pugh ve MELD skorlari ile ilişkisini araştırdık. Gereç ve Yöntem: Bu çalışma 2011-2017 yıllari arasında Gastroenteroloji ve Hepatoloji poliklinige basvuran yeni tanı siroz Hastalarının hasta kayitlari incelenerek retrospektif olarak yapilmıştır. çalışmaya alinmaaninda spontan bakteriyel peritonit, hepatik ensefalopati veya hepatosellüler karsinom tanısı olanlar ve 18 yaşindan küçük olanlar çalışmadan dislanmıştır. Bulgular: araştırma popülasyonu 78 erkek (%66.1)ve 40 kadın (%33.9) hasta olmak üzere 118 kisiden olustu. Hastalarınortalama yaşi 50.3±11.7 yıldi. Hastalarda sirozun En sık etiyolojik faktörleri hepatit B (%37.3), kriptojenik (%17.8) ve hepatit C (%11.9) idi.Hastaların ortalama takip süresi 48 aydi. Risk faktörlerinin dahil edildigiçok değişkenli stepwise Cox regresyon modelinde; hepatik ensefalopati gelismesi (HR:4.21; p=0.001), baslangiç MELD skoru (HR:1.17; p<0.001) ve C-reaktif protein-albümin orani (HR=1.22; p <0.001) mortalite riskini öngören bağımsız prediktörler olarak saptandi. C-reaktifprotein-albümin oraninda %1’lik artisin 1.22 kat mortalite riskini arttirdigi saptandi. Mortaliteyi öngörmede C-reaktif protein-albümin oraninaait kestirim değeri %77.1 duyarlilik ve %95.2 özgüllük ile ?2.4 olaraksaptandi. C-reaktif protein-albümin orani 2.4 ve üzeri olan hastalardaHES gelismesi (%35.5 vs %10.3; p=0.004), ortalama Child-Pugh skoru (7.4±1.9 vs 6.4±1.6; p <0.001), ortalama MELD skoru (14.2±3.7vs 11.8±4.1; p <0.001) ve ölenlerin orani (%87.1 vs %9.2; p <0.001)daha yüksek saptandi. Sonuç: C-reaktif protein-albümin orani yeni tanısırotik hastalarda mortalite ve siroz komplikasyonlarini öngörmede kullanilabilecek kolay ölçülebilen ve spesifitesi yüksek bir parametredir.
Background and Aims: In this study, we investigated the relationshipsbetween C-reactive protein/albumin ratio and hepatocellular carcinoma,hepatic encephalopathy, mortality, Child-Pugh score and model for endstage liver disease scores in newly diagnosed cirrhotic patients. Materials and Methods: This study was performed retrospectively by examining records of newly diagnosed cirrhotic patients who applied to theGastroenterology and Hepatology Polyclinic between 2011 and 2017.Patients who were diagnosed with hepatic encephalopathy, hepatocellular carcinoma or spontaneous bacterial peritonitis at admission, andpatients younger than 18 years were excluded from the study. Results:The study population was consisted of 118 patients; 78 men (66.1%)and 40 women (33.9%). The mean age of the patients was 50.3±11.7years. The most common etiologic factors for cirrhosis were hepatitis B(37.3%), cryptogenic (17.8%) and hepatitis C (11.9%). The mean follow-up period for the patients was 48 months. Using the multivariatestepwise Cox regression model in which risk factors were included. hepatic encephalopathy development (HR=4.21; p=0.001), initial model forend-stage liver disease score (HR=1.17; p <0.001) and C-reactive protein/albumin ratio (HR=1.22; p <0.001) were found to be independent predictors of mortality risk. A 1% increase in C-reactive protein/albumin ratio was found to increase the mortality risk 1.22-fold. The cut-off value ofC-reactive protein/albumin ratio for predicting mortality was found to be?2.4 with 77.1% sensitivity and 95.2% specificity. Development of hepatic encephalopathy (35.5% vs 10.3%, p=0.004), the mean Child-Pughscore (7.4±1.9 vs 6.4±1.6, p <0.001), the mean model for end-stageliver disease score (14.2±3.7 vs 11.8±4.1; p <0.001) and the proportionof dead patients (87.1% vs 9.2%, p <0.001) were significantly higher inpatients with a C-reactive protein/albumin ratio of 2.4 or above. Conclusion: C-reactive protein/albumin ratio is an easily measured parameterwith a high specificity that can be used in the prediction of mortality andcomplications in newly diagnosed cirrhotic patients