Hospitalised patients' albumin-globulin ratio may predict negative clinical outcomes

Aims: This research assesses the predictive capability of the ratio of serum albumin levels (ALB) to globulins levels (GLB), known as the AGR, and to determine whether this ratio may be used to anticipate adverse clinical outcomes in these patients.
Methods: This observational study was conducted at the Prince Rahid bin Al-Hussein Military Hospital in Irbid governorate to analyze medical and surgical adult patients. The study aimed to explore the prognostic performances of the assessed albumin to globulin ratio (AGR) against composited negative clinical outcomes, including a decline in creatinine clearance, liver function indices, systemic inflammatory response syndromes, sepsis, longer hospital stays, and death. Factors investigated included patients' demographics, biochemical and complete blood count laboratory results, and subjective reported data. The study focused on evaluating the AGR as an independent variable for predicting adverse clinical outcomes. The optimal threshold for the tested prognosticator of interest (AGR) was determined, and patients were divided into two groups with lower AGR than the cutoff point. A chi square test was conducted to represent the comparative distribution rates between the investigated variables.
Results: A study involving 302 patients found that 51.66% were assigned to Group I, characterized by a lower albumin to globulin ratio (AGR) below the optimal cutoff point of 0.795, and the remaining patients were classified into Group II with an AGR above 0.795. The Pearson correlation coefficient for composite outcomes of interest (cOI) was moderately high in the negative direction for the higher AGR group compared to the lower AGR group. The age distribution was evenly distributed between the lower and higher AGR groups. A binary logistic regression model was created to show the relationship between AGR and the likelihood of adverse clinical outcomes. The prognosticator AGR was evaluated to be 0.928±0.015, with a p-value of less than 0.001, indicating statistical significance. The optimal threshold for the study was 0.795, with a sensitivity of 87.8% and a specificity of 85.23%.
Conclusion: Our study found that maintaining an albumin to globulin ratio below 0.795 can have positive effects on hospitalised patients, both medically and surgically admitted, by predicting adverse clinical outcomes.