Dataset Information

Creatinine-cystatin C ratio and mortality in cancer patients: a retrospective cohort study.

ABSTRACT:

Background

Muscle wasting is prevalent in cancer patients, and early recognition of this phenomenon is important for risk stratification. Recent studies have suggested that the creatinine-cystatin C ratio may correlate with muscle mass in several patient populations. The association between creatinine-cystatin C ratio and survival was assessed in cancer patients.

Methods

A total of 3060 patients who were evaluated for serum creatinine and cystatin C levels at the time of cancer diagnosis were included. The primary outcome was 6-month mortality. The 1-year mortality, and length of intensive care unit (ICU) and hospital stay were also evaluated.

Results

The mean age was 61.6 ± 13.5 years, and 1409 patients (46.0%) were female. The median creatinine and cystatin C levels were 0.9 (interquartile range [IQR], 0.6-1.3) mg/dL and 1.0 (IQR, 0.8-1.5) mg/L, respectively, with a creatinine-cystatin C ratio range of 0.12-12.54. In the Cox proportional hazards analysis, an increase in the creatinine-cystatin C ratio was associated with a significant decrease in the 6-month mortality (per 1 creatinine-cystatin C ratio, hazard ratio [HR] 0.35; 95% confidence interval [CI], 0.28-0.44). When stratified into quartiles, the risk of 6-month mortality was significantly lower in the highest quartile (HR 0.30; 95% CI, 0.24-0.37) than in the lowest quartile. Analysis of 1-year mortality outcomes revealed similar findings. These associations were independent of confounding factors. The highest quartile was also associated with shorter lengths of ICU and hospital stay (both P < 0.001).

Conclusions

The creatinine-cystatin C ratio at the time of cancer diagnosis significantly associates with survival and hospitalization in cancer patients.

SUBMITTER: Jung CY

PROVIDER: S-EPMC9397493 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Creatinine-cystatin C ratio and mortality in cancer patients: a retrospective cohort study.

Jung Chan-Young CY Kim Hyung Woo HW Han Seung Hyeok SH Yoo Tae-Hyun TH Kang Shin-Wook SW Park Jung Tak JT

Journal of cachexia, sarcopenia and muscle 20220427 4

<h4>Background</h4>Muscle wasting is prevalent in cancer patients, and early recognition of this phenomenon is important for risk stratification. Recent studies have suggested that the creatinine-cystatin C ratio may correlate with muscle mass in several patient populations. The association between creatinine-cystatin C ratio and survival was assessed in cancer patients.<h4>Methods</h4>A total of 3060 patients who were evaluated for serum creatinine and cystatin C levels at the time of cancer di ...[more]

PMID: 35478277

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Project description:ObjectiveTo investigate the association of serum creatinine-cystatin C ratio (Cr/CysC) with long-term all-cause mortality and cause-specific (cardiovascular and cancer) mortality among US general adults.MethodsThis nationally representative cohort study included adults in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. Participants were linked to National Death Index data from the survey date through December 31, 2019. Weighted Cox proportional hazards regression models were used to calculate hazard ratios and 95% confidence intervals (CIs), and restricted cubic splines and stratified analyses were also performed.ResultsA total of 12,914 participants were included in this study (mean [SD] age, 45.3 [17.3] years; males, 48.9%). During a median follow-up of 17.9 years (maximum follow-up, 20.8 years), 3439 total deaths occurred, including 1098 cardiovascular deaths and 736 cancer deaths. Cumulative incidence curves revealed that increased Cr/CysC ratio had lower risk of all-cause (P < 0.001), cardiovascular (P < 0.001) and cancer (P < 0.001) mortality. Cox regression an Fine-Gray hazards models demonstrated that the multivariable-adjusted hazard ratios comparing the highest vs. lowest quartile of Cr/CysC ratio were 0.40 (95% CI, 0.34-0.47; P < 0.001) for all-cause mortality, 0.68 (95% CI, 0.52-0.88; P < 0.001) for cardiovascular mortality, and 0.51 (95% CI, 0.36-0.71; P < 0.001) for cancer mortality. Nonlinear association was observed for Cr/CysC ratio and all-cause mortality (P = 0.018 for nonlinearity), and linear associations were observed for Cr/CysC ratio and cardiovascular (P = 0.212 for nonlinearity) and cancer (P = 0.550 for nonlinearity) mortality. Besides, a series of sensitivity analyses ensured the robustness of the results.ConclusionsIn this cohort of US adults, Cr/CysC ratio was negatively associated with all-cause, cardiovascular, and cancer mortality. Our study suggests that Cr/CysC ratio may serve as a simple and effective predictor of long-term health outcomes.

Project description:The present study aimed to determine the association between the blood urea nitrogen (BUN) and creatinine (Cr) ratio and in-hospital mortality in patients with acute myocardial infarction (AMI). The present retrospective cohort study included adult patients (≥18 years of age) who were admitted to the intensive care unit (ICU) with a primary diagnosis of AMI. Medical records were obtained from the electronic ICU collaborative research database, which includes data from throughout continental USA. Data included demographic characteristics, vital signs, laboratory tests and comorbidities. The clinical endpoint was in-hospital mortality. The Cox proportional hazards model was used to evaluate the prognostic values of the basic BUN/Cr ratio and the Kaplan-Meier method was used to plot survival curves. Subgroup analyses were performed to measure mortality across various subgroups. In total, 5,965 eligible patients were included. In the Cox regression analysis, after being adjusted for age, sex, ethnicity and other confounding factors, the BUN/Cr ratio was found to be a significant risk predictor of in-hospital mortality. There was a non-linear relationship between the BUN/Cr ratio and in-hospital mortality after adjusting for potential confounders. A two-piecewise regression model was used to obtain a threshold inflection point value of 18. Furthermore, after adjusting for additional confounding factors (age, sex, ethnicity, BMI, heart rate, oxygen saturation, platelets, total protein, AMI category, heart failure, history of diabetes, history of hypertension, percutaneous coronary intervention, and administration of norepinephrine, dopamine and epinephrine), the BUN/Cr ratio remained a significant predictor of in-hospital mortality (third vs. first tertile: Hazard ratio, 1.50; 95% CI, 1.08-2.09; P<0.05). The Kaplan-Meier curve for tertiles of the BUN/Cr ratio indicated that in-hospital mortality rates were highest when the BUN/Cr ratio was ≥18.34 after adjustment for age, sex and ethnicity (P<0.05). The present findings demonstrated that a higher BUN/Cr ratio was associated with an increased risk of in-hospital mortality in patients with non-ST-segment elevation myocardial infarction. These results support a revision of how the prognosis of patients with AMI is predicted.

Dataset Information

Creatinine-cystatin C ratio and mortality in cancer patients: a retrospective cohort study.

Background

Methods

Results

Conclusions

Publications

Creatinine-cystatin C ratio and mortality in cancer patients: a retrospective cohort study.

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