Journal of Hebei Medical University ›› 2022, Vol. 43 ›› Issue (7): 817-821,838.doi: 10.3969/j.issn.1007-3205.2022.07.015

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The prognostic value of albumin-related ratio in children with sepsis

  

  1. First Department of Pediatric Intensive Care Unit, Hebei Children′s Hospital of Hebei Medical University, Shijiazhuang 050031, China

  • Online:2022-07-25 Published:2022-07-26

Abstract: Objective To evaluate the predictive value of albumin-related ratio in the prognosis of children with sepsis. 
Methods In total, 193 children with sepsis were selected as the research subjects. According to the 28-day survival, they were divided into survival group(n=132) and death group(n=61). The white blood cell count(WBC), neutrophil count(NEU), C-reactive protein(CRP), procalcitonin(PCT), blood lactic acid(Lac) and serum albumin(ALB) were collected within 24 h after admission. The pediatric risk of mortality Ⅲ(PRISM Ⅲ) was recorded within 24 h after PICU admission. Risk factors of death in children with sepsis, and the correlation between ALB and other indicators was analyzed; albumin-related ratio, including NEU/ALB, CRP/ALB, Lac/ALB were calculated. Receiver operating characteristic(ROC) curve was used to evaluate the predictive value of ALB, NEU/ALB, CRP/ALB, Lac/ALB, and PRISM Ⅲ in the prognosis of children with sepsis, and Kaplan Meier survival curve was drawn. 
Results PRISM Ⅲ score of death group was higher than that of survival group, while ALB was lower than that of survival group, and the difference was statistically significant(P<0.05). ALB was positively correlated with PRISM Ⅲ, NEU, CRP and Lac(P<0.05). NEU/ALB, CRP/ALB, and Lac/ALB of death group was higher than those of survival group, and the difference was statistically significant(P<0.05). Lac/ALB had the highest predictive value in 28-day mortality of children with sepsis, its sensitivity was the highest, and its specificity was second only to CRP/ALB. CRP/ALB had a lower predictive value in 28-day mortality of children with sepsis than Lac/ALB, and its sensitivity was lower. With 28-day prognosis of children with sepsis as the outcome, survival rate of patients in ALB, PRISM Ⅲ score, NEU/ALB, CRP/ALB, and Lac/ALB of normal level group was higher than that in the corresponding indexes of abnormal level group, and the difference was statistically significant(P<0.05). 
Conclusion NEU/ALB, CRP/ALB, and Lac/ALB are easily obtained prognostic indicators, which can identify septic children with poor prognosis. Lac/ALB improves the predictive value and sensitivity of prognosis in children with sepsis. 


Key words: sepsis, serum albumin, prognosis