Red Cell Distribution Width and Lactate Albumin Ratio as Prognostic Markers for Mortality in Sepsis and Septic Shock

Study Overview
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Brief Summary
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The aim of this study is to find the utility of red cell distribution width and lactate/albumin ratio as prognostic markers in sepsis and septic shock patients.

Detailed Description
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Several indicators are being used to predict the prognosis of sepsis. Commonly used prognostic indicators include Acute Physiological and chronic health evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Mortality in Emergency Department Score (MEDS), New York Sepsis severity score. Red cell distribution Width and lactate albumin ratio are being investigated for there prognostic value in septic patients.

Official Title
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Red Cell Distribution Width and Lactate Albumin Ratio as Prognostic Markers for Mortality in Sepsis and Septic Shock Patients

Conditions
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Morality, Sepsis, Septic Shock

Intervention / Treatment
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* Diagnostic Test: Red cell distribution width
* Diagnostic Test: lactate albumin ratio measurement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age from 18 to 60 years old. Clinical criteria of sepsis Or clinical criteria of septic shock including sepsis with persisting hypotension requiring vasopressors to maintain mean arterial pressure > 65 mmHg and having a serum lactate level > 2 mmol/L despite adequate volume resuscitation. Exclusion Criteria: No informed consent. Patient with incomplete information and data. The patient who received blood transfusion within 90 days before emergency admission. The patients who are known to have long-term conditions causing anemia like sickle cell anemia, thalassemia, iron deficiency anemia. Malignancy and chemotherapy during the previous 90 days. Patients with either hepatic dysfunction, renal failure, having any disease in which albumin should be supplemented as liver cirrhosis with ascites, nephrotic syndrome and burns.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Non survivors group<br>At 28 day, patients were divided into Non survivors group and Survivors group. | Diagnostic Test: Red cell distribution width<br>* Blood will be drawn from the peripheral vein, arterial or a central catheter. This procedure will be done at diagnosis, 3 ,7, 14 and 21 days of sepsis<br>Diagnostic Test: lactate albumin ratio measurement<br>* Blood will be drawn from the peripheral vein, arterial or a central catheter. This procedure will be done at diagnosis, 3 ,7, 14 and 21 days of sepsis<br>|
| Survivors group<br>At 28 day, patients were divided into Non survivors group and Survivors group. | Diagnostic Test: Red cell distribution width<br>* Blood will be drawn from the peripheral vein, arterial or a central catheter. This procedure will be done at diagnosis, 3 ,7, 14 and 21 days of sepsis<br>Diagnostic Test: lactate albumin ratio measurement<br>* Blood will be drawn from the peripheral vein, arterial or a central catheter. This procedure will be done at diagnosis, 3 ,7, 14 and 21 days of sepsis<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The prediction of mortality | The diagnostic accuracy for prediction of 28th day mortality by Red cell distribution Width and lactate albumin ratio. | 28 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of intensive care stay | Length of intensive care stay from admission till discharge either to the ward or mortality. | 28 days or till discharge from intensive care. | 
| Extent of organ dysfunctions in patients with severe sepsis and septic shock | Organ dysfunction can be confirmed by acute change in sepsis-related organ failure assessment (SOFA). | 28 days |