Biomarkers in predicting mortality among ICU patients with sepsis

Sepsis is one of the most challenging conditions in intensive care units (ICUs), with an increased incidence and mortality, making it critical to predict both mortality and timing of resuscitation. This retrospective study aimed to analyze the association of a number of routinely used biomarkers with mortality in patients admitted to the ICU with sepsis. Patients >18 years of age, who had been admitted to the ICU with sepsis were included. At admission, baseline levels of C-reactive protein (CRP), procalcitonin (PCT), albumin and lactate, as well as white blood cell (WBC), neutrophil, and lymphocyte counts were recorded. The primary outcome was 28-day mortality. Of 235 patients (92 males; mean age 73.57 ± 13.63 years), 28-day mortality occurred in 113 patients (48.1%). The non-survivors differed significantly from survivors with higher WBC, neutrophil and lymphocyte counts, higher levels of PCT, CRP and lactate, and a lower albumin level (for all, P < .05). Mortality was associated with lactate, and inversely associated with albumin levels. In logistic regression analysis, albumin and lactate were risk factors to predict 28-day mortality, with odds ratios of 1.51 and 0.89, respectively. In receiver operating characteristic analysis, PCT, lactate and albumin had the greatest values for area under the curve (0.709, 0.654, and 0.696, respectively). Besides established but time-consuming and complicated scoring systems, lactate and albumin levels may be used to predict prognosis in ICU settings, with the advantage of ease in their availability.