ABSTRACT
Several scoring systems were developed for prognosis and outcome prediction in sepsis.This study aims to evaluate the urinary albumin/creatinine ratio(ACR)as a prognosticp redictorinsepsis.The study included 50 adult septic patient sinapros pectiveobser vational study. Study excluded patients with preexisting chronic kidney disease or diabetes mellitus. After clinical evaluation, urine spot samples were collected on admission and 24h later for ACR1 and ACR2.Admission APACHEIVscoreandthehighestrecordedSOFAscoreoftheirdailyestimationwereconsidered.Thisstudyalsoevaluatedtheneedformechanicalventilation,inotropicorvasoactivesupport,renalreplacementtherapy(RRT),andin-hospitalmortality.InapopulationwithMean±SD51.4±16.3(19-82)yearoldwith34(68%)males,wefoundthattheACR2iscorrelatedwithbothAPACHEIVandSOFAscores(P<0.001).ACR2washigherinpatientswhoneededmechanicalventilationandinotropicorvasoactivesupport[121(21-235)and166.5(89-235)mg/grespectively]comparedto[49(22-120)and56.5(21-211)mg/g],P<0.001inboth.ΔACR,ACR2,increasing AC Rand APACHEIVwerepredictorsofmortality.TheAUCformortalitypredictionwaslargestforΔACR(1),increasingACR(0.985),ACR2(0.963)thenAPACHEIV(0.90).∆ACRandACR2of91.5mg/gand-22was88.2%&100%sensitiveand90.9%&100%specificrespectivelytopredictmortality.WeconcludedthattheurinaryACRmightbeusedasasimpletestforprognosisandmortalitypredictioninsepsis