Online ISSN: 2515-8260

Keywords : Febrile urinary tract infection

The procalcitonin albumin ratio as an early diagnostic predictor in discriminating urosepsis from patients with febrile urinary tract infection

1B Akhil Reddy, 2Shubhransu Patro, 3Sujit Kumar Pradhan, 4Nikunj Kishore Rout .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3332-3338

Distinguishing urosepsis from febrile urinary tract infections is critical in therapeutic decision-making to identify appropriate treatments to avoid sepsis-related organ failure. Accurate diagnosis takes time and is prone to false-positive outcomes. Furthermore, patient reactions to urosepsis are complex and variable. As a result, the goal of this study was to create a new, early diagnostic predictor that might distinguish between patients with urosepsis and those with febrile urinary tract infections by combining initial procalcitonin and albumin levels.A retrospective analysis of 200 patients with febrile urinary tract infections during an eighteen-month period. The independent risk variables for distinguishing urosepsis from febrile urinary tract infection were identified using univariate and multivariate logistic models. To examine the prediction accuracy of the procalcitonin/albumin ratio, a receiver operating characteristic (ROC) curve analysis was performed. Procalcitonin/albumin ratios were greater in the urosepsis group than in the febrile urinary tract infection group [2.254 (0.978, 6.299) vs 0.021 (0.004, 0.095); P<.001].
According to multivariate logistic analysis, the procalcitonin/albumin ratio [adjusted odds ratio (OR) 1.029, 95 percent confidence interval (CI) 1.013-1.045, P<.001] was an independent predictor of urosepsis, allowing patients with febrile urinary tract infections to be distinguished. The procalcitonin/albumin ratio had an area under the ROC curve (AUC) of 0.937 (95 percent CI, 0.894-0.980); P.001. The procalcitonin/albumin ratio cut-off values (>0.44) had a sensitivity of 84.62 percent and a specificity of 96.00 percent, respectively.Furthermore, in a sample of 65 patients with urosepsis, the procalcitonin/albumin ratio in the uroseptic shock group was greater than in the non-uroseptic shock group [5.46 (1.43, 6.58) vs 1.24 (0.63, 4.38); P =.009]. The procalcitonin/albumin ratio is an early diagnostic predictor that can distinguish between urosepsis and febrile urinary tract infection, according to our findings. Furthermore, patients with urosepsis who had greater procalcitonin/albumin ratios were more likely to develop uroseptic shock. Our findings indicate that the procalcitonin/albumin ratio is a quick and low-cost biomarker that can be employed in clinical practise.