Mortality Prediction of Microalbuminuria in Septic Patients

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.