Comparing Blood-Based Ratios for Predicting Outcomes in Sepsis and Septic Shock

Sepsis and septic shock are serious conditions associated with a high risk of organ dysfunction and death. Simple laboratory-based markers may help identify critically ill patients who are at greater risk of poor outcomes. This prospective observational cohort study compared the prognostic value of the neutrophil-to-lymphocyte ratio and the lactate-to-albumin ratio in adult patients with sepsis or septic shock admitted to the Surgical Intensive Care Unit at Benha University Hospital. A total of 60 participants were enrolled and followed for 28 days. The study evaluated the relationship of both laboratory ratios with 28-day mortality and compared their ability to predict mortality. Intensive care unit length of stay and progression of organ dysfunction were also assessed.

Inclusion Criteria: * Adults aged 18 to 60 years with clinically confirmed sepsis or septic shock. * Male and female patients. * Fulfillment of at least two quick Sequential Organ Failure Assessment criteria, including: * Glasgow Coma Scale score less than 15. * Systolic blood pressure less than 100 millimeters of mercury. * Respiratory rate greater than 22 breaths per minute. * Evidence of infection-related organ dysfunction demonstrated by an increase of more than 2 points in the Sequential Organ Failure Assessment score. * Evidence of organ dysfunction, including one or more of the following: * Ratio of arterial partial pressure of oxygen to fraction of inspired oxygen less than 300. * Glasgow Coma Scale score less than 15. * Mean arterial pressure less than 70 millimeters of mercury. * Serum creatinine greater than 1.2 milligrams per deciliter. * Urine output less than 0.5 milliliters per kilogram per hour. * Serum bilirubin greater than 1.2 milligrams per deciliter. * Platelet count less than 150,000 per microliter. * For patients with septic shock, persistent hypotension requiring vasopressors to maintain mean arterial pressure above 65 millimeters of mercury and serum lactate greater than 2 millimoles per liter despite adequate fluid resuscitation. * Ability of the patient or legally authorized representative to provide informed consent. Exclusion Criteria: * Active malignancy or chemotherapy within the previous 3 months. * Corticosteroid therapy within 90 days before admission. * Documented severe liver or kidney dysfunction. * Clinical conditions requiring albumin administration. * Pregnancy or breastfeeding. * Insufficient laboratory data or inability to complete follow-up.