Albumin, Leukosit, And Protrombin As Predictors Of Sepsis Mortality Among Adult Patients In Soetomo General Hospital, Surabaya, Indonesia

Rahmat Sayyid Zharfan, Ahmad Lukman Hakim, Abdul Khairul Rizki Purba, Soni Sunarso Sulistiawan, Bambang Pujo Semedi

= http://dx.doi.org/10.20473/ijar.V1I12019.8-12
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Abstract


Introduction: Sepsis is presented as a complex and multifactorial syndrome where the morbidity and mortality rates still high around the world. Strong evidencewith regard to early predictive factors for mortality and morbidity is rare to be provided. Objective: The aim of this study was to analyse the prominent predictors from the values of laboratory findings among patients with sepsis. Method and Material: The study was an analytic observational study with a case-control approach. The data were extracted from patients' medical records between 2014 and 2015. This study involved 50 septic patients admitted to Dr. Soetomo General Hospital, Surabaya, Indonesia. Blood urea nitrogen (BUN), creatinine serum, albumin, leukocytes count, haemoglobin, hematocrite, platelets, sodium, potassium, chloride, prothrombin time (PT), and activated partial thromboplastin time (APTT) were collected from blood samples. Logistic regression was used to estimate sepsis related mortalities frequencies and the relationship between laboratory findings and under 28-days mortality. Result and Discussion: From 50 patients, 22 patients were died (44%).The regression model was intially conducted using all three biomarkers as covariates, then using backward elimination, the covariate with the highest p-value was eliminated. The process was repeated until covariates with statistically significant remained. Multivariate analysis showed that albumin, leukocytes count, and prothrombin time (PT) were the findings associated with high mortality. The independent predictors of mortality identified by further multivariate regression analysis were taken into account as a lower than 3.5 g/dL of albumin, above12.000/µL of leukocytes count, and prolonged more than 14 seconds of prothrombin time; with p value <0,05 respectively (0.029; 0.049; 0.027). Conclusion: Notably, low albumin level, elevated levels of leukocytes, and prolonged prothrombin time were clinically considered as independent predictors of mortality among adult patients with sepsis.


Keywords


albumin, leukocyte, mortality, prothrombin time, sepsis

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References


Azrina MdRalib, Nor Zamzila Abdulah, Mohd BasriMat-Nor. Sepsis mortality score for the prediction of mortality in septic patients. Journal of Critical CareVolume 43, February 2018, Pages 163-168

Rheza N. Tambajong, Diana C. Lalenoh, Lucky Kumaat. Profil Penderita Sepsis di ICU RSUP Prof. Dr. R. D. Kandou Manado Periode Desember 2014 – November 2015. Thesis.Fakultas Kedokteran Universitas Sam Ratulangi Manado. 2016

Farzanegan B, Zangi M. Predictive factors for sepsis diagnosis, length of intensive care unit (ICU) stay and mortality in ICU. J Cell Mol Anesth. 2017;2(2):55-62.

Bárbara Magalhães Menezes, Fábio Ferreira Amorim, Adriell Ramalho Santana, Felipe Bozi Soares, Fernanda Vilas Bôas Araújo, Jacqueline Rodrigues de Carvalho, Mariana Pinheiro Barbosa de Araújo, Louise Cristhine de Carvalho Santos, Pedro Henrique Gomes Rocha, Jaqueline Lima de Souza, Mateus Gonçalves Gomes, Pedro Nery Ferreira Júnior, Alethea Patrícia Pontes Amorim, Rodrigo Santos Biondi and Rubens Antônio Bento Ribeiro. Platelet/leukocyte ratio as a predictor of mortality in patients with sepsis. Critical Care201317 (Suppl 4) :P52 https://doi.org/10.1186/cc12952

Aziz Kallikunnel Sayed Mohamed, Asmita Anilkumar Mehta, & Ponneduthamkuzhy James.Predictors of mortality of severe sepsis among adult patients in the medical Intensive Care Unit.Lung India. 2017 Jul-Aug; 34(4): 330–335.

Miriam Sanderson, Marc Chikhani, Esme Blyth, Sally Wood, Iain K Moppett, Tricia McKeever, & Mark JR Simmonds. Predicting 30-day mortality in patients with sepsis: An exploratory analysis of process of care and patient characteristics. Journal of the Intensive Care Society 0(0) 1–6The Intensive Care Society 2018

Alison Woodworth.Sepsis and the Clinical Laboratory. Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center Nashville, TN. 2013

Shapiro NI, Trzeciak S, Hollander JE, et al. A prospective, multicenter derivation of a biomarker panel to assess risk of organ dysfunction, shock, and death in emergency department patients with suspected sepsis. Crit Care Med 2009; 37:96–104.


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