Investigation of the Prognostic Value of Novel Laboratory Indices in Patients with Sepsis in an Intensive Care Unit: A Retrospective Observational Study

TL;DR

This study examined new lab tests to predict outcomes for sepsis patients in the ICU and found some may help, though more research is needed.

Contribution

The study evaluates the prognostic value of several novel laboratory indices in ICU sepsis patients.

Findings

Age, SOFA score, phosphorus levels, and CAR were independent predictors of ICU mortality.

SOFA and APACHE II scores showed high accuracy in predicting ICU mortality.

The HALP score did not significantly predict ICU mortality.

Abstract

Background: This study aimed to evaluate the prognostic value of some novel laboratory indices in intensive care unit (ICU)-hospitalized sepsis patients. Methods: This retrospective, observational study included 400 patients with sepsis. The indices studied were the C-reactive protein/albumin ratio (CAR), hemoglobin, albumin lymphocyte, and platelet (HALP) score, lymphocyte/monocyte ratio (LMR), prognostic nutritional index (PNI), systemic immune inflammatory index (SII), vitamin B12xC-reactive protein index (BCI), systemic inflammatory response index (SIRI), and platelet/lymphocyte ratio (PLR). The predicting effects of these indices in ICU mortality, along with other clinical outcomes, were investigated. Results: The median age of the study population was 73 (18–95) years and 51.6% were males. The ICU mortality rate was 51.7%. Deceased patients with sepsis had an increased age and high APACHE II and SOFA scores compared to the survivors (p < 0.05 for all). In the multivariate logistic regression analysis, age (HR = 1.069, p = 0.038 in Model 1 vs. HR = 1.053, p = 0.001 in Model 2), SOFA score (HR = 2.145, p < 0.001 in Model 1 vs. HR = 1.740, p < 0.001 in Model 2), phosphorus levels (in Model 1, HR = 0.608, p = 0.037), and CAR (in Model 2, HR = 1.012, p = 0.023) were independent associated factors for ICU mortality. According to the ROC analyses, the SOFA (AUC = 0.879, p < 0.001) and APACHE II (AUC = 0.769, p < 0.001) scores showed high accuracy in predicting ICU mortality, while the PNI (AUC = 0.675, p < 0.001), CAR (AUC = 0.609, p < 0.001), and the BCI (AUC = 0.648, p < 0.001) showed limited accuracy. However, the HALP score did not reach a significant level in predicting ICU mortality (p = 0.067). Conclusions: Excluding the HALP score, the new laboratory indices mentioned above may be prognostic markers for predicting clinical outcomes in intensive care units for patients with sepsis. However, these indices need to be supported by larger patient populations.

Figures