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Evaluation of inflammation-related prognostic scores, CRP/albumin, LDH/albumin and lactate/albumin ratios in patients with sepsis

Cilt: 18 Sayı: 3 2 Temmuz 2025
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Evaluation of inflammation-related prognostic scores, CRP/albumin, LDH/albumin and lactate/albumin ratios in patients with sepsis

Öz

Purpose: Results regarding the clinical usefulness and predictive accuracy of inflammation-based parameters, including C-reactive protein (CRP), lactate dehydrogenase (LDH), and lactate in septic patients are conflicting. In our study, we aimed to evaluate the relationships of the combination of these inflammatory parameters with albumin, disease severity and prognosis. Materials and methods: 98 patients diagnosed with sepsis were categorised as survivors (n=68) and nonsurvivors (n=30) according to their intensive care unit (ICU) mortality. Prognostic factors were evaluated with the receiver operating characteristic curve and Cox proportional hazard regression model. Survival was analyzed with the Kaplan-Meier method. Results: Compared to survivors, nonsurvivors had increased CRP and lactate (13.5 vs 10.0, p=0.044; 2.2 vs 1.7, p=0.006, respectively), while LDH and albumin levels were not significantly different (246.0 vs 245.0, p=0.624; 2.9 vs 3.0, p=0.061, respectively). When combined factors were evaluated, CRP/albumin and lactate/albumin were significantly higher in nonsurvivors (4.9 vs 3.0, p=0.018; 0.8 vs 0.5, p=0.001, respectively), while LDH/albumin was similar in both groups (93.1 vs 78.9, p=0.148). Lactate/albumin had the highest AUC of 0.709 (p=0.001), while CRP had the lowest AUC of 0.628 (p=0.044). In a multivariate analysis of possible predictors of ICU mortality, only lactate could be an independent predictor of poor outcome (HR:1.998; p=0.020), while other variables were not independently associated. Conclusion: Increased CRP, lactate, CRP/albumin and lactate/albumin levels in septic patients were associated with poor outcomes. Lactate level was an independent predictor of mortality.

Anahtar Kelimeler

Albumin, C-reactive protein, lactate, prognosis, sepsis

Proje Numarası

108/2024

Etik Beyan

This study was conducted in accordance with the Declaration of Helsinki , with the approval of the Ordu University Ethics Committee

Kaynakça

  1. Harrison C. Sepsis: calming the cytokine storm. Nat Rev Drug Discov. 2010;9(5):360-361. doi:10.1038/nrd3162
  2. Surbatovic M, Veljovic M, Jevdjic J, Popovic N, Djordjevic D, Radakovic S. Immunoinflammatory response in critically ill patients: severe sepsis and/or trauma. Mediators Inflamm. 2013;2013:362793. doi:10.1155/2013/362793
  3. Pierrakos C, Velissaris D, Bisdorff M, Marshall JC, Vincent JL. Biomarkers of sepsis: time for a reappraisal. Crit Care. 2020;24(1):287. doi:10.1186/s13054-020-02993-5
  4. Duman A, Akoz A, Kapci M, et al. Prognostic value of neglected biomarker in sepsis patients with the old and new criteria: predictive role of lactate dehydrogenase. Am J Emerg Med. 2016;34(11):2167-2171. doi:10.1016/j.ajem.2016.06.012
  5. Mendoza D, Ascuntar J, Rosero O, Jaimes F. Improving the diagnosis and prognosis of sepsis according to the sources of infection. Emerg Med J. 2022;39(4):279-283. doi:10.1136/emermed-2021-211910
  6. Bou Chebl R, Geha M, Assaf M, et al. The prognostic value of the lactate/albumin ratio for predicting mortality in septic patients presenting to the emergency department: a prospective study. Ann Med. 2021;53(1):2268-2277. doi:10.1080/07853890.2021.2009125
  7. Dugar S, Choudhary C, Duggal A. Sepsis and septic shock: Guideline-based management. Cleve Clin J Med. 2020;87(1):53-64. doi:10.3949/ccjm.87a.18143
  8. Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268-281. doi:10.1111/j.1469-0691.2011.03570.x
  9. European Committee on Antimicrobial Susceptibility Testing (EUCAST). European Society of Clinical Microbiology and Infectious Diseases. Clinical Breakpoints 2023
  10. DeLong ER, DeLong DM, Clarke Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44(3):837-845.

Kaynak Göster

APA
İlban, A., & İlban, Ö. (2025). Evaluation of inflammation-related prognostic scores, CRP/albumin, LDH/albumin and lactate/albumin ratios in patients with sepsis. Pamukkale Medical Journal, 18(3), 550-560. https://doi.org/10.31362/patd.1574623
AMA
1.İlban A, İlban Ö. Evaluation of inflammation-related prognostic scores, CRP/albumin, LDH/albumin and lactate/albumin ratios in patients with sepsis. Pam Tıp Derg. 2025;18(3):550-560. doi:10.31362/patd.1574623
Chicago
İlban, Ayşegül, ve Ömür İlban. 2025. “Evaluation of inflammation-related prognostic scores, CRP/albumin, LDH/albumin and lactate/albumin ratios in patients with sepsis”. Pamukkale Medical Journal 18 (3): 550-60. https://doi.org/10.31362/patd.1574623.
EndNote
İlban A, İlban Ö (01 Temmuz 2025) Evaluation of inflammation-related prognostic scores, CRP/albumin, LDH/albumin and lactate/albumin ratios in patients with sepsis. Pamukkale Medical Journal 18 3 550–560.
IEEE
[1]A. İlban ve Ö. İlban, “Evaluation of inflammation-related prognostic scores, CRP/albumin, LDH/albumin and lactate/albumin ratios in patients with sepsis”, Pam Tıp Derg, c. 18, sy 3, ss. 550–560, Tem. 2025, doi: 10.31362/patd.1574623.
ISNAD
İlban, Ayşegül - İlban, Ömür. “Evaluation of inflammation-related prognostic scores, CRP/albumin, LDH/albumin and lactate/albumin ratios in patients with sepsis”. Pamukkale Medical Journal 18/3 (01 Temmuz 2025): 550-560. https://doi.org/10.31362/patd.1574623.
JAMA
1.İlban A, İlban Ö. Evaluation of inflammation-related prognostic scores, CRP/albumin, LDH/albumin and lactate/albumin ratios in patients with sepsis. Pam Tıp Derg. 2025;18:550–560.
MLA
İlban, Ayşegül, ve Ömür İlban. “Evaluation of inflammation-related prognostic scores, CRP/albumin, LDH/albumin and lactate/albumin ratios in patients with sepsis”. Pamukkale Medical Journal, c. 18, sy 3, Temmuz 2025, ss. 550-6, doi:10.31362/patd.1574623.
Vancouver
1.Ayşegül İlban, Ömür İlban. Evaluation of inflammation-related prognostic scores, CRP/albumin, LDH/albumin and lactate/albumin ratios in patients with sepsis. Pam Tıp Derg. 01 Temmuz 2025;18(3):550-6. doi:10.31362/patd.1574623