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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2025-07-01
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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 |
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| 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. |
| format | Article |
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| institution | Kabale University |
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| series | BMC Gastroenterology |
| 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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