{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T16:32:19Z","timestamp":1773419539619,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81601330"],"award-info":[{"award-number":["81601330"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Necrotizing enterocolitis (NEC), a critical neonatal digestive disease, is recognized as a contributing factor to neonatal sepsis. However, the role of the C\u2010reactive protein\/albumin ratio (CAR) in diagnosing neonatal sepsis within the context of NEC remains under\u2010researched.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Our objective was to evaluate the clinical utility of the C\u2010reactive protein\/albumin (CRP\/ALB) ratio in predicting neonatal sepsis at the NEC diagnosis stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>In this retrospective analysis, we evaluated 148 NEC cases, utilizing data extracted from electronic medical records. The relationship between (CRP), (ALB) and CAR levels, and health outcomes at the point of NEC diagnosis was assessed through logistic regression. The cut\u2010off value was established using receiver operating characteristic (ROC) curves, and its effectiveness was compared with that of CRP alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the study participants, 46 (31.08%) developed neonatal sepsis. Notably, CAR levels were significantly higher in neonates with sepsis compared with those without (1.952 vs. 0.250,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Multivariate analysis indicated CAR as an independent risk factor for predicting neonatal sepsis in NEC cases (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). A CAR value &gt;\u20090.975 emerged as an independent predictor of neonatal sepsis. ROC curve analysis demonstrated that CAR effectively discriminates in predicting sepsis among NEC\u2010affected neonates (area under the receiver operating characteristic [AUC]\u2009=\u20090.70, 95% CI: 0.607\u20130.973,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), surpassing the predictive accuracy of CRP alone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study establishes CAR &gt;\u20090.975 as a novel and independent inflammatory prognostic marker linked to sepsis development in neonates with NEC. This marker could be instrumental in identifying NEC patients with a heightened risk of adverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>CAR measurement at diagnosis could personalize interventions and early detect the deterioration, and monitoring CAR supports timely care escalation, improving outcomes for critical care nurses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70071","type":"journal-article","created":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T21:29:18Z","timestamp":1748813358000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive Value of C\u2010Reactive Protein\/Albumin Ratio for Necrotizing Enterocolitis in Preterm Infants With Neonatal Sepsis"],"prefix":"10.1111","volume":"30","author":[{"given":"Keqin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Nursing, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan China"},{"name":"School of Nursing, Tongji Medical College Huazhong University of Science and Technology  Wuhan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaqi","family":"Zhu","sequence":"additional","affiliation":[{"name":"School of Nursing, Tongji Medical College Huazhong University of Science and Technology  Wuhan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinjin","family":"Guo","sequence":"additional","affiliation":[{"name":"School of Nursing, Tongji Medical College Huazhong University of Science and Technology  Wuhan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuqi","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing, Tongji Medical College Huazhong University of Science and Technology  Wuhan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jixin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9339-092X","authenticated-orcid":false,"given":"Yanwei","family":"Su","sequence":"additional","affiliation":[{"name":"School of Nursing, Tongji Medical College Huazhong University of Science and Technology  Wuhan China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,1]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.med.60.050207.092824"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31002-4"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.650709"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2008.207"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S414611"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-018-2236-1"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-021-03860-7"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1451"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1099800419827600"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4711018"},{"issue":"8","key":"e_1_2_15_12_1","first-page":"677","article-title":"Risk Factors for Concurrent Sepsis in Neonates With Necrotizing Enterocolitis","volume":"18","author":"An Y.","year":"2016","journal-title":"Zhongguo Dang Dai er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics"},{"issue":"1","key":"e_1_2_15_13_1","first-page":"1","article-title":"Clinical Guidelines for the Diagnosis and Treatment of Neonatal Necrotizing Enterocolitis (2020)","volume":"23","author":"Evidence\u2010Based Medicine Group","year":"2020","journal-title":"Zhongguo Dang Dai er Ke Za Zhi = Chinese Journal of Contemporary 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