Clinical and Laboratory Determinants of Sepsis Outcomes in General Medicine Units

Background: Sepsis has been a major cause of in-hospital mortality despite the advances that have been made to recognise and control it at an early stage. Some clinical and laboratory predictors of adverse outcomes have been identified as reliable, which is why it is necessary to identify them as early as possible to address risk stratification in general medicine units. To determine the correlation between clinical features and laboratory biomarkers and short-term outcomes in patients with sepsis and to create a predictive model of in-hospital mortality. Material and Methods: A prospective observational cohort study was conducted among adult patients hospitalised with sepsis in general medicine wards. At admission, demographic variables, comorbidities, vital parameters, and laboratory indices, such as the neutrophil-to-lymphocyte ratio (NLR), serum lactate, C-reactive protein, procalcitonin, and organ dysfunction score, were recorded. Some of the outcomes measured were in-hospital fatalities, transfer to ICU, and time spent in the hospital. The statistical comparisons of kh2 and the Mann-Whitney U test were used in a univariate statistical analysis, and multivariate analyses were conducted using logistic regression to detect independent predictors of mortality. Discriminative ability of biomarkers was measured using receiver operating characteristic (ROC) curve analysis, whereas time-to-event analyses were performed using Kaplan-Meier survival analysis and log-rank testing. Results: Advanced age, hypotension, elevated levels of lactate, elevated levels of NLR, and dysfunction of several organs were significantly correlated with mortality among patients enrolled in the study (p < 0.05). In multivariate analysis, mortality was predicted by NLR [?]9.5 (adjusted OR: 3.1; 95% CI: 1.6-5.9) and serum lactate [?]2 mmol/L (adjusted OR: 4.4; 95% CI: 2.1-9.2), both independent variables. NLR was found to be a good prognostic factor (AUC: 0.81). Conclusion: Clinical and laboratory parameters, such as serum lactate and NLR, are common and easily accessible and are strong predictors of adverse outcomes in sepsis. These findings may be used to improve risk stratification in the clinical decision-making process in general medicine units by incorporating these markers into standard assessment.

Keywords: Sepsis, Mortality, Prognosis, C-Reactive Protein.