Association between albumin to Globulin ratio and pneumonia in patients with aneurysmal subarachnoid hemorrhage

Abstract The albumin-to-globulin ratio (AGR) has been associated with infectious diseases; however, its association with pneumonia in patients with aneurysmal subarachnoid hemorrhage (aSAH) is unclear. This research aims to investigate the connection between AGR and hospital-acquired pneumonia (HAP)...

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Main Authors: Yangchun Xiao, Yu Zhang, Xin Cheng, Lvlin Cheng, Yixin Tian, Jialing He, Wenqing Wang, Wenhua Tang, Chao You, Fang Fang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-08466-5
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author Yangchun Xiao
Yu Zhang
Xin Cheng
Lvlin Cheng
Yixin Tian
Jialing He
Wenqing Wang
Wenhua Tang
Chao You
Fang Fang
author_facet Yangchun Xiao
Yu Zhang
Xin Cheng
Lvlin Cheng
Yixin Tian
Jialing He
Wenqing Wang
Wenhua Tang
Chao You
Fang Fang
author_sort Yangchun Xiao
collection DOAJ
description Abstract The albumin-to-globulin ratio (AGR) has been associated with infectious diseases; however, its association with pneumonia in patients with aneurysmal subarachnoid hemorrhage (aSAH) is unclear. This research aims to investigate the connection between AGR and hospital-acquired pneumonia (HAP). This retrospective analysis included 4,813 patients with aSAH from West China Hospital, Sichuan University. Serum samples were collected within seven days after admission. Logistic regression analysis was conducted to assess the association between AGR and HAP. Among the 4,813 patients, 1,249 (26.0%) developed HAP. The patients were classified into quartiles according to their AGR levels. Significant differences in odds ratios (ORs) were found in admission AGR: 0.76 (95% CI 0.63–0.93, p = 0.007) for Q2, 0.78 (95% CI 0.64–0.94, p = 0.016) for Q3, and 0.77 (95% CI 0.63–0.94, p = 0.012) for Q4 versus Q1. ORs of minimum AGR were: 0.67 (95% CI 0.57–0.80, p < 0.001) for Q2, 0.45(95% CI 0.37–0.54, p < 0.001) for Q3, and 0.24 (95% CI 0.20–0.30, p < 0.001) for Q4. ORs for AGR drift: 1.19 (95% CI 0.93–1.52, p = 0.18) for Q2, 1.35 (95% CI 1.06–1.73, p = 0.015) for Q3, and 2.00 (95% CI 1.57–2.55, p < 0.001) for Q4. Furthermore, admission AGR (< 1.21) and minimum AGR (< 0.99) were linked to elevated CURB-65 scores3–5 in HAP patients, yielding ORs of 0.46 (95% CI 0.27–0.77, p = 0.003) and 0.44 (95% CI 0.27–0.69, p < 0.001). AGR was associated with an increased risk of HAP. Furthermore, lower minimum AGR was associated with increased severity of HAP among aSAH patients. Further research is necessary to confirm this finding and investigate the underlying mechanisms.
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spelling doaj-art-aba7cd14c3df47729a35c15e4626b6af2025-08-20T03:42:33ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-08466-5Association between albumin to Globulin ratio and pneumonia in patients with aneurysmal subarachnoid hemorrhageYangchun Xiao0Yu Zhang1Xin Cheng2Lvlin Cheng3Yixin Tian4Jialing He5Wenqing Wang6Wenhua Tang7Chao You8Fang Fang9Department of Neurosurgery, Clinical Medical College and Affiliated, Hospital of Chengdu UniversityDepartment of Neurosurgery, Clinical Medical College and Affiliated, Hospital of Chengdu UniversityDepartment of Neurosurgery, West China Hospital, Sichuan UniversityDepartment of Neurosurgery, Clinical Medical College and Affiliated, Hospital of Chengdu UniversityDepartment of Neurosurgery, West China Hospital, Sichuan UniversityDepartment of Neurosurgery, West China Hospital, Sichuan UniversityDepartment of Neurosurgery, Clinical Medical College and Affiliated, Hospital of Chengdu UniversityDepartment of Neurosurgery, Clinical Medical College and Affiliated, Hospital of Chengdu UniversityDepartment of Neurosurgery, West China Hospital, Sichuan UniversityDepartment of Neurosurgery, West China Hospital, Sichuan UniversityAbstract The albumin-to-globulin ratio (AGR) has been associated with infectious diseases; however, its association with pneumonia in patients with aneurysmal subarachnoid hemorrhage (aSAH) is unclear. This research aims to investigate the connection between AGR and hospital-acquired pneumonia (HAP). This retrospective analysis included 4,813 patients with aSAH from West China Hospital, Sichuan University. Serum samples were collected within seven days after admission. Logistic regression analysis was conducted to assess the association between AGR and HAP. Among the 4,813 patients, 1,249 (26.0%) developed HAP. The patients were classified into quartiles according to their AGR levels. Significant differences in odds ratios (ORs) were found in admission AGR: 0.76 (95% CI 0.63–0.93, p = 0.007) for Q2, 0.78 (95% CI 0.64–0.94, p = 0.016) for Q3, and 0.77 (95% CI 0.63–0.94, p = 0.012) for Q4 versus Q1. ORs of minimum AGR were: 0.67 (95% CI 0.57–0.80, p < 0.001) for Q2, 0.45(95% CI 0.37–0.54, p < 0.001) for Q3, and 0.24 (95% CI 0.20–0.30, p < 0.001) for Q4. ORs for AGR drift: 1.19 (95% CI 0.93–1.52, p = 0.18) for Q2, 1.35 (95% CI 1.06–1.73, p = 0.015) for Q3, and 2.00 (95% CI 1.57–2.55, p < 0.001) for Q4. Furthermore, admission AGR (< 1.21) and minimum AGR (< 0.99) were linked to elevated CURB-65 scores3–5 in HAP patients, yielding ORs of 0.46 (95% CI 0.27–0.77, p = 0.003) and 0.44 (95% CI 0.27–0.69, p < 0.001). AGR was associated with an increased risk of HAP. Furthermore, lower minimum AGR was associated with increased severity of HAP among aSAH patients. Further research is necessary to confirm this finding and investigate the underlying mechanisms.https://doi.org/10.1038/s41598-025-08466-5AneurysmalSubarachnoid hemorrhageGlobulinAlbuminRatioSeverity
spellingShingle Yangchun Xiao
Yu Zhang
Xin Cheng
Lvlin Cheng
Yixin Tian
Jialing He
Wenqing Wang
Wenhua Tang
Chao You
Fang Fang
Association between albumin to Globulin ratio and pneumonia in patients with aneurysmal subarachnoid hemorrhage
Scientific Reports
Aneurysmal
Subarachnoid hemorrhage
Globulin
Albumin
Ratio
Severity
title Association between albumin to Globulin ratio and pneumonia in patients with aneurysmal subarachnoid hemorrhage
title_full Association between albumin to Globulin ratio and pneumonia in patients with aneurysmal subarachnoid hemorrhage
title_fullStr Association between albumin to Globulin ratio and pneumonia in patients with aneurysmal subarachnoid hemorrhage
title_full_unstemmed Association between albumin to Globulin ratio and pneumonia in patients with aneurysmal subarachnoid hemorrhage
title_short Association between albumin to Globulin ratio and pneumonia in patients with aneurysmal subarachnoid hemorrhage
title_sort association between albumin to globulin ratio and pneumonia in patients with aneurysmal subarachnoid hemorrhage
topic Aneurysmal
Subarachnoid hemorrhage
Globulin
Albumin
Ratio
Severity
url https://doi.org/10.1038/s41598-025-08466-5
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