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Mortality Prediction of Microalbuminuria in Septic Patients
1Critical Care Department, Cairo University Hospitals, Cairo, Egypt.
Background:
Huge number of pro-inflammatory and anti-inflammatory markers is produced during the process of sepsis. Its mortality prediction value needs to be determined.
Aim:
To assess the prognostic value of Albumin creatinine ratio (ACR) in septic patients and its ability to predict mortality in comparison with Acute physiology and chronic health evaluation II score (APACHE II).
Methods:
Seventy-five Septic patients were included within 24 hours of sepsis diagnosis and were admitted to the intensive care unit (ICU). ACR values were obtained within 6 hours of ICU admission for all patients. Prognostic scoring systems [APACHE II and Sequential organ failure assessment (SOFA) scores] were calculated.
Results:
Twenty percent of enrolled patients died within 28 days of hospital admission. ACR was significantly higher in non-survivor in comparison to survivors (55.1 ± 20.5 versus 30.2 ± 35.7, p = 0.006). ACR ≥ 40 (mg/gm creatinine) was the cut-off point for predicting mortality with a sensitivity of 90.7% and specificity of 71.8% with total accuracy of 66% and AUC 0.75 (CI 0.62-0.88). Mean APACHE II score was significantly higher in non-survivors than survivor groups (21.4 versus 10.8, p < 0.001). ACR was positively correlated with highest SOFA score (r = 0.3, P < 0.05).
Conclusion:
ACR is a simple prognostic marker in septic patient and could be used as a mortality predictor, particularly in early (within 6 hours) septic patients.
Insights
Albumin creatinine ratio (ACR) can predict mortality in sepsis patients. This simple marker, assessed early, shows significant prognostic value compared to APACHE II scores.
Area of Science:
- Critical Care Medicine
- Nephrology
- Biomarkers
Background:
- Sepsis involves numerous pro- and anti-inflammatory markers.
- Accurate mortality prediction in sepsis remains a clinical challenge.
Purpose of the Study:
- To evaluate the prognostic utility of Albumin creatinine ratio (ACR) in predicting mortality among septic patients.
- To compare the predictive performance of ACR against the APACHE II score.
Main Methods:
- Seventy-five septic patients were enrolled within 24 hours of diagnosis and admitted to the ICU.
- Albumin creatinine ratio (ACR) was measured within 6 hours of ICU admission.
- APACHE II and SOFA scores were calculated for prognostic assessment.
Main Results:
- Twenty percent of patients died within 28 days.
- Non-survivors had significantly higher ACR levels than survivors (p=0.006).
- ACR ≥ 40 mg/gm creatinine predicted mortality with 90.7% sensitivity and 71.8% specificity (AUC 0.75).
- APACHE II scores were also higher in non-survivors (p<0.001).
- ACR correlated positively with SOFA scores (r=0.3, P<0.05).
Conclusions:
- Albumin creatinine ratio (ACR) serves as a straightforward prognostic marker for sepsis.
- ACR demonstrates potential as an early mortality predictor in septic patients, particularly within 6 hours of presentation.
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