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ORIGINAL RESEARCH article

Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1484370

Association between the serum-albumin-creatinine ratio and 28-day ICU intensive care unit 28-day mortality among patients with sepsis: a multicenter retrospective cohort study

Provisionally accepted
Weiguo Lin Weiguo Lin 1Cheng Fu Cheng Fu 2*Jiangwei Miao Jiangwei Miao 1*WeiLi Hong WeiLi Hong 1*Xinglin Chen Xinglin Chen 3Shaorong Yan Shaorong Yan 1*Yuzhan L Yuzhan L 1*
  • 1 Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
  • 2 Ruian Hospital of Traditional Chinese Medicine, Wenzhou, Zhejiang Province, China
  • 3 National Academy of Chinese Theatre Arts, Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    Abstract Introduction: Sepsis is a substantial global health challenge with considerable disease burden. Despite advancements in sepsis research, the mortality rates associated with this condition remain high. The relationship between the serum albumin-to-creatinine ratio (sACR) and mortality in patients with sepsis remains unclear. Therefore, this study aimed to investigate the association between the sACR and 28-day mortality in intensive care unit (ICU) patients with sepsis. Methods: In this retrospective cohort study, we used data sourced from the eICU Collaborative Research Database. The primary exposure variable was sACR, and the primary outcome measure was mortality within 28 days after ICU admission. Statistical analyses included univariate and multivariate logistic regression models, generalized additive models, and two-piecewise linear regression models, which were employed to explore non-linear relationships and threshold effects between sACR and mortality. Results: The study cohort comprised 9,690 ICU patients with sepsis, with a 28-day mortality rate of 9.99%. The results of the multivariate logistic regression model indicated that elevated sACR levels were significantly associated with a reduced risk of mortality (odds ratio = 0.78, 95% confidence interval: 0.71–0.87, P < 0.001), even after adjusting for potential confounding variables. Curve fitting revealed a non-linear relationship between sACR and 28-day mortality, with an inflection point of 4.79. Discussion: This study demonstrated that sACR is an independent risk factor for 28-day mortality in ICU patients with sepsis, exhibiting a non-linear negative dose–response relationship and a threshold effect. These findings may serve as early warning indicators in high-risk populations.

    Keywords: Sepsis, serum albumin creatinine ratio, (sACR), 28-day mortality, Intensive Care Unit, (ICU), Retrospective cohort study

    Received: 21 Aug 2024; Accepted: 14 Oct 2024.

    Copyright: © 2024 Lin, Fu, Miao, Hong, Chen, Yan and L. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Cheng Fu, Ruian Hospital of Traditional Chinese Medicine, Wenzhou, Zhejiang Province, China
    Jiangwei Miao, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
    WeiLi Hong, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
    Shaorong Yan, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
    Yuzhan L, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.