The C-Reactive Protein/Albumin Ratio Is Useful for Predicting Short-Term Survival in Cancer and Noncancer Patients

J Palliat Med. 2019 May;22(5):532-537. doi: 10.1089/jpm.2018.0404. Epub 2018 Dec 20.


Objective and Background: Survival predictions by subjective evaluations are important for end-stage patients. However, subjective evaluations based on experience are difficult. Therefore, we investigated whether the Glasgow prognostic score (GPS), prognostic nutritional index (PNI), and C-reactive protein (CRP)/albumin ratio (CRP/Alb ratio) calculated from the laboratory values of objective evaluations are useful for predicting survival times in end-stage patients. Methods: We retrospectively investigated the age, sex, death cause, CRP levels, Alb levels, and lymphocyte counts in 363 cancer and noncancer patients who died in the 12-month period between April 2015 and March 2016. A multivariate analysis was performed to calculate GPS, PNI, and the CRP/Alb ratio from laboratory values and adjusted for confounding factors. Results: PNI and CRP/Alb ratio exhibited negative and positive correlations with survival days, respectively. All GPS, PNI, and CRP/Alb ratio were useful to predict two to four remaining weeks. Interestingly, CRP/Alb ratio, but not GPS or PNI, was higher in patients with predicted short-term survival of zero to two weeks than in that of two to four weeks (odds ratio 2.32; 95% confidence interval 1.61-3.34). Discussion: These results suggest that the CRP/Alb ratio is an independent factor that is beneficial to predict short-term survival of within two weeks.

Keywords: CRP/Alb ratio; Glasgow prognostic score; prognosis; prognostic nutritional index.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Albumins / analysis*
  • Biomarkers, Tumor / analysis*
  • C-Reactive Protein / analysis*
  • Female
  • Humans
  • Japan
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasms / physiopathology*
  • Predictive Value of Tests*
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Analysis


  • Albumins
  • Biomarkers, Tumor
  • C-Reactive Protein