Abstract
Background This study is aimed at investigating whether albumin-to-fibrinogen ratio (AFR) could independently predict the prognosis in patients with peritonitis-induced sepsis. Methods A total of 246 eligible patients who were scheduled to undergo surgical treatment for peritonitis-induced sepsis were enrolled in this study. The primary observational endpoint was 28-day hospital mortality. Cox proportional hazards regression analysis with the Wald test was performed to identify prognostic factors for 28-day mortality in septic patients. Receiver operating characteristic (ROC) and Kaplan-Meier curve analyses were carried out to evaluate the association of baseline AFR and prognosis in septic patients. Results Of all the cohort study participants, there were 59 nonsurvivors with a 28-day mortality of 24.0% (59/246). Baseline AFR (hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.42–0.93, P = 0.018) and the presence of septic shock (HR: 2.43, 95% CI: 1.42–3.91, P = 0.021) were two independent prognostic factors for 28-day mortality in patients with peritonitis-induced sepsis by multivariate Cox analysis. Baseline AFR was a significant predictor for 28-day mortality with an area under the curve (AUC) of 0.751, a cut-off value of 8.85, a sensitivity of 66.10%, and a specificity of 70.05%, respectively (95% CI: 0.688–0.813, P < 0.001). A low baseline AFR level (≤8.85) was significantly associated with a lower overall survival rate in septic patients by Kaplan-Meier curve analysis with log-rank test (P = 0.004). Conclusions This study indicates that AFR independently predicts 28-day mortality in patients with peritonitis-induced sepsis.
Highlights
As one of the most common causes of postoperative death, the incidence of sepsis was increasing, the same as organ dysfunction [1]
Despite advances in the pathophysiology understanding and therapeutic strategy improvement, the mortality rate caused by severe sepsis or septic shock still remains high [2]
Inclusion criteria are as follows: (1) adult patients aged over 18 years with both gender; (2) presence of sepsis according to the definition criteria [7] induced by acute peritonitis; and (3) admitted to the intensive care unit (ICU) after emergency abdominal surgery
Summary
As one of the most common causes of postoperative death, the incidence of sepsis was increasing, the same as organ dysfunction [1]. This study is aimed at investigating whether albumin-to-fibrinogen ratio (AFR) could independently predict the prognosis in patients with peritonitis-induced sepsis. Cox proportional hazards regression analysis with the Wald test was performed to identify prognostic factors for 28-day mortality in septic patients. Baseline AFR (hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.42–0.93, P = 0:018) and the presence of septic shock (HR: 2.43, 95% CI: 1.42–3.91, P = 0:021) were two independent prognostic factors for 28-day mortality in patients with peritonitis-induced sepsis by multivariate Cox analysis. A low baseline AFR level (≤8.85) was significantly associated with a lower overall survival rate in septic patients by Kaplan-Meier curve analysis with logrank test (P = 0:004). This study indicates that AFR independently predicts 28-day mortality in patients with peritonitis-induced sepsis
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