Introduction:
This study aims to evaluate the efficacy of the procalcitonin/albumin (PCT/ALB) ratio in predicting the prognosis of patients with acute kidney injury (AKI) caused by sepsis secondary to bloodstream infection.
Methods:
Patients aged 18 years and older, diagnosed with sepsis-associated acute kidney injury (S-AKI), and admitted to the Intensive Care Unit (ICU) between September 2018 and September 2020 were included in this study. S-AKI was defined as AKI resulting from primary bloodstream infection, infective endocarditis, or catheter-related bloodstream infection. Based on 28-day outcomes, the patients were categorized into a survival group and a death group. Within 48 hours of ICU admission, various biochemical parameters, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sepsis-Related Organ Failure Assessment (SOFA) score, Glasgow Coma Scale (GCS) score, oxygenation index, and mechanical ventilation duration were recorded. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to identify risk factors influencing 28-day mortality in S-AKI patients and to assess the prognostic value of the PCT/ALB ratio.
Results:
The APACHE II score, SOFA score, PCT/ALB ratio, PCT levels, C-reactive protein (CRP) levels, and international normalized ratio (INR) were significantly higher in the death group compared to the survival group (P<0.05). In contrast, platelet count, total protein (TP), albumin (ALB), alanine aminotransferase (ALT), and partial pressure of carbon dioxide (PaCO2) were significantly lower in the death group (P<0.05). Multivariate regression analysis identified the PCT/ALB ratio, TP levels, and APACHE II score as independent predictors of mortality in S-AKI patients (P<0.05). The area under the ROC curve (AUC) for predicting 28-day mortality using the PCT/ALB ratio was 0.943, with a cutoff value of 0.810, a sensitivity of 0.904, and a specificity of 0.906. For TP levels, the AUC was 0.661, with a cutoff value of 0.316, a sensitivity of 0.731, and a specificity of 0.585. Additionally, the AUC for APACHE II score was 0.809, with a cutoff value of 0.564, a sensitivity of 0.904, and a specificity of 0.660.
Conclusions:
The PCT/ALB ratio is a valuable prognostic indicator for assessing the severity of bloodstream infections in S-AKI patients and holds significant clinical relevance in predicting 28-day mortality.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.