Relationship Between Preoperative Serum Albumin and Uric Acid and One-year Cure Rate in Patients With Herpes Zoster.

Background: Herpes zoster (HZ) is a common condition that causes severe pain mostly in middle-aged and older adults. It is currently treated with a combination of medication and surgery. However, some patients do not experience complete pain relief even after surgery and often experience a period of mild pain until a complete cure. Some studies suggest that the development of HZ is markedly associated with antioxidant factors; however, the relationship between preoperative antioxidant factors and the prognosis of HZ remains undetermined.

Objectives: Our study aimed to investigate the relationship between preoperative antioxidant factors and the one-year cure rate in patients with HZ.

Study Design: A retrospective, observational study.

Setting: The study was carried out in the Pain Department of the First Hospital Affiliated to Jiaxing College in Jiaxing, People's Republic of China.

Methods: The clinicopathological data of the patients who were admitted with HZ neuralgia at the First Hospital of Jiaxing from October 2021 through October 2022 were retrospectively analyzed, and their pain cure was followed up over the telephone. Furthermore, the optimal cut-off value of the antioxidant factor was assessed via the receiver operating characteristic (ROC) curve, whereas to evaluate the relationship between the antioxidant factor and various clinicopathologic characteristics of the patient, a c2 was performed. The Kaplan-Meier method was utilized to estimate the cure rate at one year. Moreover, the Cox regression model was used to assess the association of antioxidant factors with the prognosis of patients with HZ neuralgia. Lastly, ROC curves were generated to predict the effect of albumin (ALB), uric acid (UA), and combined ALB-UA (Co ALB-UA) on the patient's prognosis.

Results: A total of 225 patients were included in this study: 138 women and 87 men, with the median age of 62 years. The cure rate at one year was significantly higher in the ALB, UA, total bilirubin level (TBL), and homocysteine (HCY) groups than in the low value group (83.1%vs 41.6%, 73.7% vs 55.0%, 70.4% vs 52.1%, 71.3% vs 57.3% respectively, P < 0.05). The multifactorial Cox regression model indicated that the preoperative Numeric Rating Scale pain score (hazard ratio [HR] = 0.630; 95% CI, 0.437-0.907; P < 0.05), ALB (HR = 3.221; 95% CI, 2.212-4.690; P < 0.05), and UA (HR = 1.691; 95% CI, 1.182-2.419; P < 0.05) were identified as independent protective factors for a complete cure. An ROC curve analysis showed that the area under the curve of ALB, TBL, UA, HCY, and Co ALB-UA was 0.731 (95% CI, 0.658-0.805), 0.597 (95% CI, 0.518-0.675), 0.704 (95% CI, 0.633-0.774), 0.587 (95% CI, 0.508-0.666), and 0.777 (95% CI, 0.716-0.837) respectively. Additionally, the Co ALB-UA was more important than the individual antioxidant factors in evaluating a prognosis.

Limitations: Major limitations of this study are its nonrandomized, single-center, and retrospective design.

Conclusions: ALB and UA are independent risk factors and reflect the prognosis of patients with HZ neuralgia. Furthermore, their combined application may improve prediction accuracy.