Comparative Analysis of Crp/Albumin Ratio, Procalcitonin/Albumin Ratio, and Lactate/Albumin Ratio for Predicting 28-Day Mortality in Icu Patients with Sepsis

Abstract

Introduction: Sepsis, a life-threatening condition caused by the body's overreaction to infection, remains a leading cause of death in ICUs. Despite better care, septic patient mortality is hard to predict. The SOFA score has been used for this purpose in the past. But other markers like CRP, procalcitonin, and lactate, when combined in ratios with albumin, have been useful as prognostic markers.

Objective: The aim of this study is to evaluate the CRP/albumin ratio (CAR), procalcitonin/albumin ratio (PAR), and lactate/albumin ratio (LAR) as independent predictors of 28-day mortality in patients with sepsis in the ICU, and contrast them with the predictive ability of the SOFA score.

Methods: A prospective observational study of 105 ICU patients with sepsis was analyzed. The measurements made were CRP, procalcitonin, lactate, and albumin. Differences in CAR, PAR, and LAR values were compared against the SOFA score to predict a prognosis that categorized in which group the patient would be at 28 days. Test results for significance were evaluated using the Mann-Whitney U test and the ROC curve.

Results: Non-survivors exhibited significantly higher CAR, PAR, LAR, and SOFA scores compared to survivors. ROC curve analysis revealed PAR to be the best predictor of 28-day mortality (AUC = 0.978) followed by CAR and LAR. While CAR and LAR were less powerful predictors of mortality, they also provided good information regarding patient outcome and the severity of the disease in the management of sepsis.

Conclusion: PAR is a superior 28-day mortality predictor among sepsis patients compared with SOFA, CAR, and LAR. While CAR and LAR are still beneficial, PAR is more predictive, and therefore it is a useful risk stratification and management tool in the critical care setting.