A study of microalbuminuria in sepsis with reference to acute physiology and chronic health evaluation II score in patients admitted to a medical intensive care unit

Abstract

Background: Prediction of outcome of critically ill patients helps in early aggressive therapy, optimum resource allocation and counselling of the family. This study was conceived to assess the predictive value of microalbuminuria, which is an underutilised biomarker. Methods: This was a longitudinal observational study conducted between March 2018 and June 2019 to assess microalbuminuria in patients with and without sepsis and to evaluate whether the degree of microalbuminuria could predict mortality in sepsis, and its association with to the acute physiology and chronic health evaluation II (APACHE II) score and the sequential organ failure assessment (SOFA) scores. Results: Among the 105 patients studied, 56 (53.3%) were male. This included patients with sepsis (n = 51) and without-sepsis (n = 54). The mean APACHE II score in sepsis group was 11.5 ± 3.5, in non-sepsis group was 8.2 ± 3.7 and overall was 9.8 ± 4.0. SOFA score in sepsis group was 3.0 ± 1.5, in non-sepsis group was 1.19 ± 1.15 and overall was 2.0 ± 1.6. The mean albumin/creatinine ratio (ACR) 1 and ACR2 among survivors were 150.5 ± 95.2 and 152.2 ± 87.2 and among non-survivors were 230.9 ± 43.9 and 287.8 ± 8.70, respectively. ACR2 performed similar to APACHE II in predicting mortality (difference between areas = 0.239; standard error = 0.0593 [95% confidence intervals: 0.123–0.355]; P = 0.0001). Conclusions: ACR2 had the highest value among ACR1, ACR2 and APACHE II for predicting mortality.

Keywords

• acute physiology and chronic health evaluation ii
• microalbuminuria
• mortality
• predictor
• sepsis