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

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.