Prognostic value of baseline APACHE II score combined with uric acid concentration for short-term clinical outcomes in patients with sepsis

Abstract

To our knowledge, no study to date has assessed the ability of baseline Acute Physiology and Chronic Health Evaluation (APACHE) II score plus uric acid (UA) concentration to predict short-term clinical outcomes in patients with sepsis. This single-center retrospective cohort study analyzed 432 patients with sepsis who were followed up for at least 30-days between January 2016 and December 2018. The endpoint was death from any cause. Patients were categorized into four groups according to baseline APACHE II score and UA concentration, and the relationships between these parameters and all-cause in-hospital and 30-day mortality rates were analyzed. The in-hospital and 30-day all-cause mortality rates were 23.1% and 31.5%, respectively. Cox proportional hazard analysis showed that, after adjustment for confounding factors, APACHE II score ≥17.5 plus UA concentration ≥296.27 µmol/L were independently predictive of 30-day mortality (adjusted Model 1: hazard ratio [HR]=9.30, P=0.001; adjusted Model 2: HR=5.01, P=0.019). APACHE II score plus UA concentration was a strong independent predictor of short-term clinical outcomes in patients with sepsis. A higher APACHE II score plus higher UA concentration was significantly associated with adverse short-term outcomes.