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The association between C-reactive protein (CRP)/Albumin Ratio (CAR) and the outcomes of patients with Ludwig's Angina

  • I Made Candra Purnama ,
  • Dwi Hari Susilo ,
  • Maryono Dwi Wibowo ,


Link of Video Abstract:


Background: A severe form of widespread cellulitis that affects the submandibular and submental regions is known as Ludwig's angina. The C-reactive protein/Albumin Ratio (CAR) was utilized to evaluate the prognosis of several different disorders. This research aims to evaluate the correlation between CAR and mortality as well as the outcome of patients with Ludwig's Angina. Additionally, it seeks to determine the optimal CAR ratio threshold for predicting mortality in Ludwig's Angina patients.

Methods: This study presents a retrospective cohort analysis of patients diagnosed with Ludwig's Angina aged over 20 years and underwent operative treatment at RSUD Dr. Soetomo Surabaya between January 2018 and April 2023. Data were analyzed using SPSS version 23.0 for Windows.

Results: 121 patients diagnosed with Ludwig's Angina were recruited for the study. In this study, most research subjects (65.4%) were male. The percentage of cases classified as mild, moderate, or severe was 5.4%, 58.5%, and 36.2%, respectively. The calculated cutoff value for CAR was determined to be 8.87. The model's sensitivity was 66%, indicating its ability to identify positive cases correctly. Similarly, the model's specificity was determined to be 66.3%, demonstrating its ability to identify negative cases correctly. The p-values for the relationship between CAR and patient outcome, severity, and length of stay (LOS) were found to be 0.001, 0.028, and 0.014 in each case.

Conclusion: The C-reactive protein/Albumin (CAR) ratio, which serves as an inflammatory marker, can be utilized to evaluate the mortality rate associated with Ludwig's Angina. This tool can stratify patients diagnosed with Ludwig's Angina.


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How to Cite

Purnama, I. M. C., Susilo, D. H., & Wibowo, M. D. (2023). The association between C-reactive protein (CRP)/Albumin Ratio (CAR) and the outcomes of patients with Ludwig’s Angina. Bali Medical Journal, 12(3), 3180–3186.




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I Made Candra Purnama
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Dwi Hari Susilo
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Maryono Dwi Wibowo
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