The CRP/ALB ratio of ≥ 3 on day 3 had the best predictive ability at sensitivity of 76.4% (95% CI 63.7–85.6) and specificity of 71.9% (95% CI 62.2–79.9) in predicting surgery for NEC with a AUC of 0.72 [(95% CI 0.64–0.81); p < 0.0001] (Fig. 1a). Here, ALB is linked to necrotizing enterocolitis.