Katakam Santhoshi N, Cherukuri Mounika, Kada Mayank, Hanji Pooja, Kudru Chandrashekar U
Department of General Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of General Medicine, Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana, India.
Indian J Crit Care Med. 2025 May;29(5):407-412. doi: 10.5005/jp-journals-10071-24968. Epub 2025 May 8.
Sepsis is an oxidative state characterized by a dysregulated immune response to infection, causing multiorgan dysfunction. Uric acid, with its dual role in oxidation and antioxidation, may influence sepsis severity and outcomes. This study aimed to investigate the association between hyperuricemia and the severity and clinical outcomes in sepsis patients.
A prospective, observational cohort study was conducted in medical intensive care units (ICUs) from February 2023 to May 2024. A total of 224 patients aged ≥18 years with clinical suspicion of sepsis and sequential organ failure assessment (SOFA) score ≥2 on admission were enrolled. The patients were divided into hyperuricemic (serum uric acid ≥7 mg/dL) and normouricemic groups.
One hundred and twelve patients were enrolled in each group. The hyperuricemic group had significantly higher SOFA (7 vs 5, = 0.001) and Acute Physiology and Chronic Health Evaluation (APACHE) II (33.5 vs 18, = 0.001) scores. They also had higher rates of shock at admission (23.2% vs 12%, = 0.036), acute kidney injury (AKI) (89.3% vs 58%, = 0.001), need for hemodialysis (42.9% vs 23.2%, = 0.002), and longer ICU stays (6 vs 4 days, = 0.003). Mortality was higher in the hyperuricemic group (25% vs 13.4%, = 0.052). Kaplan-Meier analysis revealed significantly lower survival rates in hyperuricemic patients (log-rank test, = 0.022). Multivariate analysis identified hyperuricemia as an independent predictor of poor outcomes.
Hyperuricemia is associated with increased severity of illness and a higher incidence of AKI, prolonged ICU stays, and increased mortality in sepsis.
Katakam SN, Cherukuri M, Kada M, Hanji P, Kudru CU. The Prognostic Significance of Serum Uric Acid in Sepsis: A Comparative Study on Adult Patients. Indian J Crit Care Med 2025;29(5):407-412.
脓毒症是一种氧化状态，其特征为对感染的免疫反应失调，可导致多器官功能障碍。尿酸在氧化和抗氧化方面具有双重作用，可能会影响脓毒症的严重程度和预后。本研究旨在探讨脓毒症患者高尿酸血症与严重程度及临床预后之间的关联。
于2023年2月至2024年5月在医疗重症监护病房（ICU）进行了一项前瞻性观察队列研究。共纳入224例年龄≥18岁、临床怀疑脓毒症且入院时序贯器官衰竭评估（SOFA）评分≥2的患者。将患者分为高尿酸血症组（血清尿酸≥7mg/dL）和正常尿酸血症组。
每组纳入112例患者。高尿酸血症组的SOFA评分（7对5，P = 0.001）和急性生理与慢性健康状况评估（APACHE）II评分（33.5对18，P = 0.001）显著更高。他们入院时休克发生率（23.2%对12%，P = （此处原文有误，推测应为P = 0.036））、急性肾损伤（AKI）发生率（89.3%对58%，P = 0.001）、需要血液透析的比例（42.9%对23.2%，P = 0.002）也更高，且在ICU的住院时间更长（6天对4天，P = 0.003）。高尿酸血症组的死亡率更高（25%对13.4%，P = 0.052）。Kaplan-Meier分析显示高尿酸血症患者的生存率显著更低（对数秩检验，P = 0.022）。多变量分析确定高尿酸血症是不良预后的独立预测因素。
高尿酸血症与脓毒症患者病情严重程度增加、AKI发生率更高、ICU住院时间延长及死亡率增加相关。
Katakam SN, Cherukuri M, Kada M, Hanji P, Kudru CU. 脓毒症中血清尿酸的预后意义：一项针对成年患者的比较研究。《印度重症监护医学杂志》2025；29(5):407 - 412。
