Assessment of INR to Albumin Ratio in Predicting Outcome During Hospital Stay in Patients with Cirrhosis of Liver with Sepsis.

Cirrhosis of Liver is a frequent consequence of the long clinical course of all chronic liver diseases, and it is characterised by tissue fibrosis and the transformation of normal liver architecture into structurally abnormal nodules. The prothrombin time-international normalized ratio (PT-INR) to Albumin Ratio (PTAR SCORE) created by Haruki et al. can be quickly calculated at the patient's bedside using a simple formula, INR divided by Serum albumin. Material: A total of 93 patients were entered into the hospital based observational study, and all the participants were followed up during hospital stay. Our study aimed to estimate the international normalized ratio and albumin levels in patients of cirrhosis of liver with sepsis and to find out the association between PT-INR to Albumin Ratio (PTAR Score) on the day of admission with patients outcome during hospital stay.

• q SOFA score was calculated for all the patients at the time of admission. A score of two or more points in patients with presumed infection defines sepsis
• Patients of cirrhosis of liver with presumed infection and qSOFA score ≥2 were recruited for the study up on fulfillment of the inclusion and exclusion criteria.
• The PTAR score on the day of admission was calculated by using a simple formula, INR divided by albumin.
• Based on this score, patients were classified as low-risk (PTAR score < 0.55), intermediate-risk (PTAR score 0.55-1.00), or high-risk (PTAR score > 1.00).
• These patients were then followed up and found out the outcome (discharged/expired) during the hospital stay.

Observation: The association between the risk of mortality during hospital stay and PTAR score remained statistically significant. The PTAR score showed good discrimination ability for predicting mortality during hospital stay. To improve its feasibility, we regrouped the PTAR scores into three levels of risk (low risk: <0.55, intermediate risk:0.55-1.00, and high risk: ≥1.00); the in hospital mortality rates were 14.29% (4/28), 23.08% (9/39), and 76.93% (20/26), respectively. Conclusion: The PTAR score system is a convenient and practical tool for predicting the prognosis of patients with cirrhosis of liver with sepsis.