Serial Serum Albumin Combined with Uric Acid Levels vs SOFA Score as Predictors of Outcome in Post Surgical Sepsis Patients on Mechanical Ventilation

Abstract Background: In critically ill post‑surgical septic patients on mechanical ventilation, early identification of those at highest risk of mortality remains challenging. The SOFA score is widely used to quantify organ dysfunction, but integrating simple biochemical markers—serial serum albumin and uric acid—may enhance prognostic accuracy. Objective: To compare the predictive utility of SOFA score alone versus a combined biomarker panel (serial serum albumin and uric acid) for mortality in post‑surgical sepsis patients on mechanical ventilation. Methods: In this prospective observational cohort at BRD Medical College ICU, 120 adult patients with postoperative sepsis requiring mechanical ventilation were enrolled. SOFA scores and blood samples were obtained on Days 1, 3, 5, and 7. Serum albumin (bromocresol green), uric acid (colorimetric), and SOFA were recorded. Primary outcome was in‑ICU mortality. Continuous variables (mean ± SD) were compared by t‑test; Pearson’s r assessed correlations; ROC analysis evaluated discriminative performance. Results: Non‑survivors (n=85) had significantly higher mean SOFA (9.21 ± 2.1 vs 5.62 ± 3.2; p<0.001) and uric acid, and lower albumin throughout (all p<0.05). Uric acid correlated positively with mortality (r=0.280–0.282) and SOFA (r=0.180–0.188); albumin correlated negatively with mortality (r=–0.199 to –0.501) and SOFA (r=–0.241 on Day 5). SOFA AUC for mortality was 0.847; combined biomarker AUC (albumin + uric acid) reached 0.902. Conclusions: While SOFA score remains a strong predictor, adding serial serum albumin and uric acid measurably improves prognostic discrimination. Routine monitoring of these accessible biomarkers can help stratify risk and guide early interventions in mechanically ventilated surgical sepsis patients.