Usefulness of serum creatinine-to-albumin ratio for 28-day all-cause mortality in critically ill patients with atrial fibrillation: A retrospective study based on the MIMIC-IV database.
W, L., L, G., & H, H. (2026). Usefulness of serum creatinine-to-albumin ratio for 28-day all-cause mortality in critically ill patients with atrial fibrillation: A retrospective study based on the MIMIC-IV database.. Medicine. https://doi.org/10.1097/MD.0000000000048651
W L, L G, H H. Usefulness of serum creatinine-to-albumin ratio for 28-day all-cause mortality in critically ill patients with atrial fibrillation: A retrospective study based on the MIMIC-IV database.. Medicine. 2026; doi: 10.1097/MD.0000000000048651
W L, L G, H H. Usefulness of serum creatinine-to-albumin ratio for 28-day all-cause mortality in critically ill patients with atrial fibrillation: A retrospective study based on the MIMIC-IV database.[J]. Medicine. 2026. DOI: 10.1097/MD.0000000000048651.
@article{w2026,
author = {Li W and Guo L and Huang H},
title = {Usefulness of serum creatinine-to-albumin ratio for 28-day all-cause mortality in critically ill patients with atrial fibrillation: A retrospective study based on the MIMIC-IV database.},
journal = {Medicine},
year = {2026},
doi = {10.1097/MD.0000000000048651},
note = {PMID: 42260807},
}
TY - JOUR AU - Li W AU - Guo L AU - Huang H TI - Usefulness of serum creatinine-to-albumin ratio for 28-day all-cause mortality in critically ill patients with atrial fibrillation: A retrospective study based on the MIMIC-IV database. T2 - Medicine PY - 2026 DO - 10.1097/MD.0000000000048651 AN - PMID:42260807 ER -
Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and is associated with increased short-term mortality in critically ill patients. The creatinine-to-albumin ratio (CAR) is associated with adverse outcomes in various clinical settings. This study investigated the association between CAR and 28-day all-cause mortality and evaluated its contribution to a clinical prediction model. A total of 4501 critically ill patients with AF were identified from the Medical Information Mart for Intensive Care IV database. The optimal cutoff value for CAR was determined using X-tile software, and the patients were categorized into high (>0.5) and low (≤0.5) CAR groups. The Kaplan-Meier analysis demonstrated a significantly lower 28-day survival in patients with elevated CAR. The CAR showed good discriminative ability for 28-day mortality. In multivariate Cox regression analyses, CAR remained independently associated with 28-day mortality, both as a continuous variable (hazard ratio = 1.211, 95% confidence interval = 1.061-1.381, P = .004) and as a categorical variables (>0.5 vs ≤0.5; hazard ratio = 1.377, 95% confidence interval = 1.175-1.615, P < .001). Restricted cubic spline analysis revealed a significant nonlinear dose-response relationship between CAR and mortality risk. Subgroup analyses showed consistent associations across most prespecified subgroups. A multivariate prediction model incorporating CAR was used to construct a nomogram that demonstrated good discrimination, calibration, and clinical utility. Overall, elevated CAR was independently and consistently associated with an increased risk of short-term mortality in critically ill patients with AF. In addition, the nomogram incorporating CAR demonstrated strong predictive performance. Given its routine availability and biological plausibility, CAR may serve as a simple and practical biomarker for early risk stratification and individualized prognostic assessment in this high-risk population.