Publication

Abstract : Sepsis is a systemic, deleterious host response to infection. It is associated with high morbidity and mortality. Sepsis is a major cause of Emergency Medicine Department admission. Acute phase reactants (APR) are involved in the pathophysiological process that occurs during an inflammation and tissue injury. C-reactive protein (CRP) is a positive acute phase protein whereas serum albumin (ALB) is a negative acute phase protein. CRP/Albumin ratio can be a useful method to identify the severity and prognosis in sepsis. Hence, we did this study to identify the role of CRP/Albumin ratio (CAR) as a diagnostic and prognostic marker in sepsis presenting to the emergency department (ED). Methodology: 2-year prospective survey of 66 septic patients who was admitted to the ED of a tertiary care center in South India. Patients more than 18 years with suspected infection along with two or more criteria of sepsis were included in the study. CRP and Albumin were analysed from the venous blood sample on admission to the ED itself. Chi square test was done to find the association between categorical variables. ROC curve and AUC was used. Severity of sepsis based on severe sepsis and septic shock and prognosis was evaluated: Result 66 patients who fulfilled the inclusion criteria were included in the study. In our study population, the mean age was 57.15 ± 16.54 years and 68.2% were males. 50% developed septic shock. In a 45-day follow up, non-Survivor and survivor were 59.1% and 40.9% respectively. The mortality rate of patients admitted with severe sepsis and septic shock are 30.3% and 87.9%, respectively. CRP/Albumin ratio (p value = 0.049) was found to be statistically significant when compared to CRP alone (p value = 0.139) for predicting the severity of sepsis. CRP/Albumin ratio (p value = 0.008) was found to be statistically more significant when compared to CRP alone (p value = 0.050) for predicting the prognosis. We were also able to find a statistical correlation (p < 0.001) between severity of the disease and the prognosis. Conclusion: CRP/Albumin ratio (CAR) is a useful diagnostic and prognostic marker in sepsis.