الفهرس 
SEPSISOnly 14 pages are availabe for public view
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Abstract
Sepsis remains a major global healthcare concern, owing to high morbidity and mortality, despite the advances in medical therapeutics. Targeted therapies probably lose their efficacy due to late administration. Early administration of intensive therapy to critically ill patients has shown promise in improving mortality. An early event is the loss of barrier integrity leading to systemic capillary leak which is manifested as increased excretion of albumin in the urine. Microalbuminuria, defined as 30–300 mg/day of albumin excretion in the urine is a common finding in critically ill patients, where it has shown promise not only as a predictor of organ failure and vasopressor requirement but of mortality, faring better than SAPS II and APACHE II score.
This study was conducted at Ain Shams University Hospitals and portsaid governorate Hospitals to evaluate the degree of microalbuminuria in sepsis patients and whether it could predict mortality in critically ill sepsis patients and also to evaluate the relationship between microalbuminuria and SAPS II score.
After getting approval from ethical committee 45 patients presented with features of SIRS and suspected infection were included after fulfilling the exclusion criteria. Urine for Albumin creatinine ratio was done at 6 hours (ACR1) and at 24 hours (ACR2) of admission and SAPS II Score was calculated in the first 24 hours of admission.
1) Total 45 patients were included in the study, Patients were distributed from age 24 to 86 years. Mean age of the study population was 63.050 years among survivors and 69.800 years among non survivors. Patients with age > 60 years constituted 80% of the study population.
2) Out of 45 patients 26 patients (57.77%) were males and 19 patients were females (42.22%).
3) 27 patients (60%) had all the 4 criteria for SIRS, 16 patients (35.5%) had 3 criteria and 2 patients (4.5%) had 2 criteria.
4) Mortality percentage in this study was 55.56%. Mortality was maximum among those aged >40 years. Age of non-survivors patients ranging from 49 to 86 years with Mean of 69.800 years.
5) SAPS II score ranged from 18 to 107 with a mean score of about 39.200 among survivors and 69.680 among non survivors with statistically significant P value of <0.001.
6) Mean Urine ACR 1 among survivors was 81.395 μg/mg and among non Survivors 670.680 and ACR 2 was 70.350 among survivors and 681.920 among non survivors. Both were statistically significant with p value of 0.0001.
7) All of 25 non survived patients (100%) had SAPS II score more than 50 and both Urine ACR1 and Urine ACR2 more than 150 with statistically significant p-value of <0.001 of each of them.