{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:56:11Z","timestamp":1792788971689,"version":"4.5.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Jilin Provincial Department of Education","award":["JJKH20210062KJ"],"award-info":[{"award-number":["JJKH20210062KJ"]}]},{"DOI":"10.13039\/100015800","name":"Development and Reform Commission of Jilin Province","doi-asserted-by":"crossref","award":["2021C018"],"award-info":[{"award-number":["2021C018"]}],"id":[{"id":"10.13039\/100015800","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The C-reactive protein\/albumin ratio (CAR) could serve as an novel obtainable application for prognosis. Few studies have assessed CAR and mortality in older Japanese patients with post-stroke dysphagia (PSD). We evaluated CAR as a composite prognostic factor and compared its predictive performance with C-reactive protein (CRP) and albumin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, 133 elderly Japanese patients with PSD (January 2014\u2013January 2017) were analyzed. Cox proportional hazards models estimated associations of CAR, CRP, and albumin with mortality. Survival across CAR tertiles was compared by Kaplan\u2013Meier curves. For 1-year mortality prediction we computed ROC curves and assessed incremental value using IDI and NRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 133 patients (78 women, 55 men; mean age 80.5\u202fyears), each one-unit increase in CAR was associated with a 42% higher hazard of death in unadjusted analysis (HR 1.42; 95% CI 1.18\u20131.71;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and remained significant after full adjustment (HR 1.49; 95% CI 1.16\u20131.92;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002). Higher CAR tertiles had worse survival (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001). For 1-year mortality discrimination, CAR AUC\u202f=\u202f0.702 (95% CI 0.606\u20130.798), albumin AUC\u202f=\u202f0.710, CRP AUC\u202f=\u202f0.685. Albumin improved prediction over CAR (IDI 0.108,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.012; NRI 0.217,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.044); CRP did not.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CAR was positively associated with mortality in older Japanese patients with PSD but had only modest discrimination for 1-year mortality. Albumin provided a small additional predictive benefit. Larger prospective studies are needed for validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1648517","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T05:15:49Z","timestamp":1763702149000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Association between C-reactive protein\/albumin ratio and mortality in older Japanese patients with post-stroke dysphagia"],"prefix":"10.3389","volume":"16","author":[{"given":"Ziying","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingling","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1805","DOI":"10.1172\/JCI200318921","article-title":"C-reactive protein: a critical update","volume":"111","author":"Pepys","year":"2003","journal-title":"J Clin Invest"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"s18","DOI":"10.2450\/2013.005s","article-title":"Clinical use of albumin","author":"Caraceni","year":"2013","journal-title":"Blood Transfus"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.1038\/s41416-020-01254-0","article-title":"Systemic inflammation scores correlate with survival prognosis in patients with newly diagnosed brain metastases","volume":"124","author":"Starzer","year":"2021","journal-title":"Br J Cancer"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"39","DOI":"10.3390\/jcm7030039","article-title":"C-reactive protein to albumin ratio predicts 30-day and 1-year mortality in postoperative patients after admission to the intensive care unit","volume":"7","author":"Oh","year":"2018","journal-title":"J Clin Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"101035","DOI":"10.1016\/j.tranon.2021.101035","article-title":"C-reactive protein-to-albumin ratio is an independent poor prognostic factor in newly diagnosed chronic lymphocytic leukaemia: a clinical analysis of 322 cases","volume":"14","author":"Tang","year":"2021","journal-title":"Transl Oncol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"109682","DOI":"10.1016\/j.intimp.2023.109682","article-title":"C-reactive protein\/albumin and C-reactive protein\/fibrinogen ratios for the diagnosis of periprosthetic joint infection in revision total joint arthroplasty","volume":"115","author":"Wu","year":"2023","journal-title":"Int Immunopharmacol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1007\/s12020-024-03875-4","article-title":"C-reactive protein to albumin ratio and risk of incident metabolic syndrome in community-dwelling adults: longitudinal findings over a 12-year follow-up period","volume":"86","author":"Lim","year":"2024","journal-title":"Endocrine"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1002\/jcsm.13512","article-title":"Swallowing muscle mass contributes to post-stroke dysphagia in ischemic stroke patients undergoing mechanical thrombectomy","volume":"15","author":"Pinho","year":"2024","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2756","DOI":"10.1161\/01.STR.0000190056.76543.eb","article-title":"Dysphagia after stroke: incidence, diagnosis, and pulmonary complications","volume":"36","author":"Martino","year":"2005","journal-title":"Stroke"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"31","DOI":"10.5582\/bst.2025.01029","article-title":"Post-stroke dysphagia: neurological regulation and recovery strategies","volume":"19","author":"Li","year":"2025","journal-title":"Biosci Trends"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"5067","DOI":"10.3390\/jcm11175067","article-title":"Prognostic value of C-reactive protein and albumin in Neurocritically ill patients with acute stroke","volume":"11","author":"Jang","year":"2022","journal-title":"J Clin Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"492","DOI":"10.5582\/bst.2024.01220","article-title":"Financial inclusion and financial gerontology in Japan's aging society","volume":"18","author":"Kinoshita","year":"2024","journal-title":"Biosci Trends"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e0217120","DOI":"10.1371\/journal.pone.0217120","article-title":"Comparison of long-term outcomes between enteral nutrition via gastrostomy and total parenteral nutrition in older persons with dysphagia: a propensity-matched cohort study","volume":"14","author":"Masaki","year":"2019","journal-title":"PLoS One"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"21150","DOI":"10.1038\/s41598-025-07327-5","article-title":"Prognostic value of the C-reactive protein to albumin ratio in patients with stroke: a meta-analysis","volume":"15","author":"Yang","year":"2025","journal-title":"Sci Rep"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"815","DOI":"10.2147\/CIA.S482214","article-title":"Effects of HALP score, C-reactive protein\/albumin ratio, and platelet\/lymphocyte ratio on predicting mortality in geriatric patients in the respiratory intensive care unit","volume":"20","author":"Ulu\u00e7","year":"2025","journal-title":"Clin Interv Aging"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1370763","DOI":"10.3389\/fnut.2024.1370763","article-title":"Association between the C-reactive protein\/albumin ratio and mortality in older Japanese patients with dysphagia","volume":"11","author":"Guo","year":"2024","journal-title":"Front Nutr"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1275748","DOI":"10.3389\/fnins.2023.1275748","article-title":"Research hotspots and trends in post-stroke dysphagia: a bibliometric analysis","volume":"17","author":"Xu","year":"2023","journal-title":"Front Neurosci"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1097\/MRR.0000000000000385","article-title":"Post-stroke dysphagia rehabilitation in the old and oldest old: outcome and relevance for discharge home","volume":"43","author":"Castagna","year":"2020","journal-title":"Int J Rehabil Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1111\/jnc.13973","article-title":"C-reactive protein in the detection of post-stroke infections: systematic review and individual participant data analysis","volume":"141","author":"Bustamante","year":"2017","journal-title":"J Neurochem"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e2675","DOI":"10.1002\/brb3.2675","article-title":"Hypersensitive C-reactive protein-albumin ratio is associated with stroke-associated pneumonia and early clinical outcomes in patients with acute ischemic stroke","volume":"12","author":"Huang","year":"2022","journal-title":"Brain Behav"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"341","DOI":"10.18071\/isz.77.0341","article-title":"Predictors of pneumonia in stroke patients with dysphagia: A Turkish study. A t\u00fcd\u0151gyullad\u00e1s el\u0151rejelz\u0151i dysphagi\u00e1s stroke-betegekben: Egy t\u00f6r\u00f6k tanulm\u00e1ny","volume":"77","author":"Ka\u015fik\u00e7i","year":"2024","journal-title":"Ideggyogy Sz"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1648517\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T05:15:51Z","timestamp":1763702151000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1648517\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,21]]},"references-count":21,"alternative-id":["10.3389\/fneur.2025.1648517"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1648517","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,21]]},"article-number":"1648517"}}