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Evaluation of the predictive power of d-dimer/albumin ratio and fibrinogen/albumin ratio for in-hospital mortality in COVID-19 patients

Introduction: Due to the high mortality of coronavirus disease 2019
(COVID-19), There are difficulties in the management of the emergency
department. As such, we investigated whether the d-dimer/albumin ratio
(DAR) and fibrinogen/albumin ratio (FAR) predicts mortality in the
COVID-19 patients. Methods: A total of 717 COVID-19 patients who were
brought to the emergency department within the period from March to
October 2020 were included in the study. The d-dimer level, fibrinogen
level, albumin level, DAR, FAR, age, gender, and in-hospital mortality
status of the patients were recorded. The patients were grouped by
in-hospital mortality. Statistical comparison was conducted between the
groups. Results: Of the patients who were included in the study,
371(51.7%) were male, and their median age was 64 years (50–74). There
was in-hospital mortality in 126 (17.6%) patients. The
area-under-the-curve (AUC) and odds ratio values obtained by DAR to
predict in-hospital mortality were higher than the values obtained by
the all other parameters (AUC of DAR, albumin, d-dimer, FAR, and
fibrinogen: 0.773, 0.766, 0.757, 0.703, and 0.637, respectively; odds
ratio of DAR>56.36, albumin<4.015,
d-dimer>292.5, FAR>112.33, and
fibrinogen>423: 7.898, 6.216, 6.058, 4.437, and 2.794,
respectively). In addition; patients with concurrent
DAR>56.36 and FAR>112.33 had an odds ratio of
21.879 referring to patients with concurrent DAR<56.36 and
FAR<112.33. Conclusion: DAR was found to be more valuable than
the other parameters. In addition the concurrent high levels of DAR and
FAR levels were found to be more valuable in predicting in-hospital
mortality compared to a separate evaluation. Keywords: Covid-19,
D-dimer, Fibrinogen, Serum Albumin, in-Hospital Mortality