To Study the Correlation or Association of Serum Uric Acid Level with Morbidities and Mortality in Sepsis Patient and its Prognostic Significance.

UNLABELLED

Sepsis becomes a life threatening condition, which diagnosed clinically with simple q-SOFA score at bedside. In sepsis there is increased oxidative stress due to high oxygen free radicals and low levels of antioxidants causing multi-organs failure, one of which is kidney dysfunction, resulting in inhibition of uric acid (UA) excretion, causing rise in serum UA. Thus UA can be a marker of severity of oxidative stress and poor prognosis in patients with sepsis.

MATERIAL

This was a prospective cohort study, conducted from March 2020 to August 2021 at tertiary care centre in the state of Madhya Pradesh, India. Study includes 80 patients with clinical diagnosis of sepsis in age group of ≥16 and ≤60 years of both sexes; who were admitted in Medicine ICU and wards. Clinical diagnosis of sepsis was based on 2016-Sepsis- 3 criteria including q-SOFA score. The patients were divided into two study groups: with serum UA level <7 mg/dl and with serum UA level ≥7 mg/dl.

OBSERVATION

In present study 45(56.30%) cases were males and 35(43.80%) females. It has been observed that the cases with q-SOFA score-3 (52 or 65%) and serum UA level ≥7 mg/dl were have poor outcome (death) (Chi square =1.875, p value =0.171) compared to cases with q-SOFA score-2 (28 or 35%) and serum UA level <7 mg/ dl (Chi square =1.33, p =0.248). Cases with q-SOFA score -3 were observed with positive association between pre existing co-morbidities at admission and their poor clinical outcomes (Pearson Chi-Square =7.216, p =0.007). It was further observed that cases with very high level of serum UA level (>9 to 12mg/dl) group have more chance of poor outcome (P =0.22). Cases with high UA value (≥7 mg/dl) have longer duration of hospital stay and shows positive association between duration of hospital stay and serum UA level at admission (Chi square =10.94, p =0.012).

CONCLUSION

It is concluded that the raised serum UA value in sepsis patients at their admission have positive association with poor outcomes and longer duration of hospital stay. Hence, in favourable condition serum UA may determine a useful early prognostic marker in sepsis patient at admission. However, further large case control study will be required to establish this hypothesis.