Prognostic value of the international normalized ratio to albumin ratio in acute pancreatitis: insights from MIMIC-IV database

Abstract Background While the prognostic value of the international normalized ratio - to - albumin ratio (PTAR) has been established in several diseases, its predictive value in acute pancreatitis (AP) mortality remains uncertain. This study aimed to investigate the association between PTAR and sur...

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Main Authors: XingYi Yang, Yi Ying, Min Zhang, LiHong Lv, XiaoXiao Wang, JunWei Fang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-04103-7
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author XingYi Yang
Yi Ying
Min Zhang
LiHong Lv
XiaoXiao Wang
JunWei Fang
author_facet XingYi Yang
Yi Ying
Min Zhang
LiHong Lv
XiaoXiao Wang
JunWei Fang
author_sort XingYi Yang
collection DOAJ
description Abstract Background While the prognostic value of the international normalized ratio - to - albumin ratio (PTAR) has been established in several diseases, its predictive value in acute pancreatitis (AP) mortality remains uncertain. This study aimed to investigate the association between PTAR and survival outcomes in AP patients. Methods Initial screening using univariate and multivariate regression analysis identified significant prognostic variables. Survival distributions according to different PTAR levels were compared using the Kaplan - Meier (K - M) method. Receiver operating characteristic (ROC) curves were used to evaluate its discriminative performance in terms of sensitivity and specificity. Nonlinear relationships of PTAR with survival outcomes were assessed using restricted cubic spline (RCS) regression, and stratified cohort examinations were conducted to address potential confounding effects. Result A total of 459 patients were enrolled in this study. They were categorized into two groups based on their PTAR scores: high - risk (≥ 0.58) and low - risk (< 0.58). A significant association was found between elevated PTAR and increased mortality at various time points, such as 7, 14, 21, 28, 90, and 365 days (P < 0.05). The Cox proportional hazards model revealed a significant independent association between higher PTAR and mortality, with hazard ratios consistently significant across all time points (P < 0.05). Patients in the high - risk group showed persistently higher mortality rates (P < 0.05 for all comparative time points). ROC analysis showed similar predictive performance of PTAR and the SOFA score for mortality. No statistically significant interaction between PTAR status and treatment effects was observed (p > 0.05). Conclusion PTAR has shown significant associations with clinical outcomes in patients with AP.
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spelling doaj-art-ffc4507b9a694e9e807caacdd301b59d2025-08-20T03:43:15ZengBMCBMC Gastroenterology1471-230X2025-07-0125111110.1186/s12876-025-04103-7Prognostic value of the international normalized ratio to albumin ratio in acute pancreatitis: insights from MIMIC-IV databaseXingYi Yang0Yi Ying1Min Zhang2LiHong Lv3XiaoXiao Wang4JunWei Fang5Department of Gastroenterology Disease, XianJu People’s Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People’s Hospital, Affiliated Xianju’s Hospital, Hangzhou Medical CollegeDepartment of Gastroenterology Disease, XianJu People’s Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People’s Hospital, Affiliated Xianju’s Hospital, Hangzhou Medical CollegeDepartment of Gastroenterology Disease, XianJu People’s Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People’s Hospital, Affiliated Xianju’s Hospital, Hangzhou Medical CollegeDepartment of Gastroenterology Disease, XianJu People’s Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People’s Hospital, Affiliated Xianju’s Hospital, Hangzhou Medical CollegeDepartment of Gastroenterology Disease, XianJu People’s Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People’s Hospital, Affiliated Xianju’s Hospital, Hangzhou Medical CollegeDepartment of Gastroenterology Disease, XianJu People’s Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People’s Hospital, Affiliated Xianju’s Hospital, Hangzhou Medical CollegeAbstract Background While the prognostic value of the international normalized ratio - to - albumin ratio (PTAR) has been established in several diseases, its predictive value in acute pancreatitis (AP) mortality remains uncertain. This study aimed to investigate the association between PTAR and survival outcomes in AP patients. Methods Initial screening using univariate and multivariate regression analysis identified significant prognostic variables. Survival distributions according to different PTAR levels were compared using the Kaplan - Meier (K - M) method. Receiver operating characteristic (ROC) curves were used to evaluate its discriminative performance in terms of sensitivity and specificity. Nonlinear relationships of PTAR with survival outcomes were assessed using restricted cubic spline (RCS) regression, and stratified cohort examinations were conducted to address potential confounding effects. Result A total of 459 patients were enrolled in this study. They were categorized into two groups based on their PTAR scores: high - risk (≥ 0.58) and low - risk (< 0.58). A significant association was found between elevated PTAR and increased mortality at various time points, such as 7, 14, 21, 28, 90, and 365 days (P < 0.05). The Cox proportional hazards model revealed a significant independent association between higher PTAR and mortality, with hazard ratios consistently significant across all time points (P < 0.05). Patients in the high - risk group showed persistently higher mortality rates (P < 0.05 for all comparative time points). ROC analysis showed similar predictive performance of PTAR and the SOFA score for mortality. No statistically significant interaction between PTAR status and treatment effects was observed (p > 0.05). Conclusion PTAR has shown significant associations with clinical outcomes in patients with AP.https://doi.org/10.1186/s12876-025-04103-7International normalized ratio to albumin ratioMortalityAcute pancreatitis
spellingShingle XingYi Yang
Yi Ying
Min Zhang
LiHong Lv
XiaoXiao Wang
JunWei Fang
Prognostic value of the international normalized ratio to albumin ratio in acute pancreatitis: insights from MIMIC-IV database
BMC Gastroenterology
International normalized ratio to albumin ratio
Mortality
Acute pancreatitis
title Prognostic value of the international normalized ratio to albumin ratio in acute pancreatitis: insights from MIMIC-IV database
title_full Prognostic value of the international normalized ratio to albumin ratio in acute pancreatitis: insights from MIMIC-IV database
title_fullStr Prognostic value of the international normalized ratio to albumin ratio in acute pancreatitis: insights from MIMIC-IV database
title_full_unstemmed Prognostic value of the international normalized ratio to albumin ratio in acute pancreatitis: insights from MIMIC-IV database
title_short Prognostic value of the international normalized ratio to albumin ratio in acute pancreatitis: insights from MIMIC-IV database
title_sort prognostic value of the international normalized ratio to albumin ratio in acute pancreatitis insights from mimic iv database
topic International normalized ratio to albumin ratio
Mortality
Acute pancreatitis
url https://doi.org/10.1186/s12876-025-04103-7
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AT minzhang prognosticvalueoftheinternationalnormalizedratiotoalbuminratioinacutepancreatitisinsightsfrommimicivdatabase
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