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ORIGINAL ARTICLE
Year : 2020  |  Volume : 7  |  Issue : 1  |  Page : 117-123

Microalbuminuria as an early postoperative detector of sepsis after major surgeries


Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Correspondence Address:
MD Ali A Mahareak
6308 King Khalid Street, 62461-4080 Khamis Mushait, Saudi Arabia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_28_19

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Background Recently, many prognostic markers have been developed for early prediction of sepsis. Purpose To study if microalbuminuria has an early detection value in surgical sepsis and is correlated with other scoring systems. Patients and methods This observational prospective correlation study was done in Al-Azhar University hospitals. A total of 26 patients aged between 21 and 65 years were included in the study. Patients were chosen after 48 h of admission to the ICU after major surgeries. The patients were evaluated upon admission and 24 h later for manifestations of sepsis. Spot urine samples were obtained at the preoperative time, on ICU admission [albumin/creatinine ratio 1 (ACR1)], 24 h postoperative (ACR2), and 48 h postoperative (ACR3). ICU scoring systems included Acute Physiological and Chronic Health Evaluation II (APACHE II) score evaluated every 24 h for 72 h, and the Sequential Organ Function Assessment (SOFA) score was evaluated daily until ICU discharge or up to a total of 28 days. Results A total of 26 patients were involved in this correlational study after exclusions. There was no correlation between ACR1 and APACHE II score or SOFA score or the length of ICU stay. There was a positive correlation between ACR2 and ACR3 with APACHE score on day 1 and day 2 and SOFA score on day 1 and day 2. There was a positive correlation between ACR2 and ACR3 and the length of ICU stay. There was no statistically significant difference between ACR on admission, ACR on day 1, and ACR on day 2 in patients who needed vasopressors and those who needed dialysis therapy. Only ACR2 was a significant predictor for mortality in our patient population. Conclusion Microalbuminuria a simple and ready tool that has a unique prognostic value in patients with sepsis following major surgeries.


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