Could Serum lactate/albumin ratio and Blood urea nitrogen /albumin ratio be Promising Prognostic Predictors in Patients with Sepsis and Septic shock? a retrospective cohort study

Abstract Background Earlier recognition together with ultimate management of sepsis can avert its progression and decrease the associated morbidity and mortality.So biomarkers can help clinician in early detection of high risk septic patients. Serum lactate is one of the most important markers for reflecting impaired oxygen delivery and tissue perfusion associated with increased anaerobic glycolysis.Albumin level in serum is affected also by various circumstances. So that combination of both as lactate/albumin ratio may increase the prognostic performance in mortality prediction. Moreover measuring ratio of blood urea nitrogen / serum albumin (BAR) in the recent decades has a promising valuable role for predicting mortality. So the aim was to assess prognostic performance of both serum lactate /Albumin ratio and ratio of blood urea nitrogen /albumin as predictors for sepsis and septic shock outcomes. Results A retrospective observational cohort research article was conducted at Respiratory Intensive Care Unit (RICU) and Surgical ICUs on 140 sepsis and/or septic shock patients (admitted with or developed while staying in ICU);furtherly subdivided into 2 groups according to final outcome ( Survived = 115,Non-survived = 25),their mean age was 53.98 ± 17.3. Statistically significant increase in BMI, SOFA score, APACHE II score, Duration of invasive MV, Duration of vasopressors need among non- survivors. Increased serum lactate levels at 24 h following septic shock development, increased L\A ratio and BAR levels had significantly increased mortality. Conclusions Elevated L/A ratio and BAR ratio were associated with significanthigher mortality risk,poor outcome among septic patients in ICU; giving promising good prognostic values.