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Background <p>The serum uric acid to albumin ratio (UAR) is a recently recognized composite inflammatory biomarker that has not received sufficient attention in relation to sepsis. This study aimed to investigate the association between UAR and the risk of all-cause mortality in critically ill patients with sepsis.</p> Methods <p>We conducted an analysis using a retrospective database of sepsis patients who were admitted to the Affiliated Hospital of Jiangsu University between January 2015 and November 2023. The patients were divided into four groups based on UAR quartiles. The primary outcome was in-hospital all-cause mortality. The Kaplan-Meier curve and log-rank tests were used to evaluate all-cause mortality among the four groups. Cox proportional hazards regression analysis and restricted cubic splines were performed to examine the association between UAR and clinical outcomes in patients with sepsis. Subgroup analyses were conducted to evaluate the impact of other variables on the relationship between UAR and all-cause mortality.</p> Results <p>A total of 1123 patients (63.0% males) were included in this study. The in-hospital and intensive care unit (ICU) mortality rates were 33.9% and 31.7%, respectively. There was a significant association between higher UAR levels and an increased cumulative incidence of 30-/60-day mortality (log-rank test, <i>P</i> &lt; 0.001). Cox proportional hazards regression analysis demonstrated that the UAR was independently associated with a higher risk of in-hospital mortality [per SD increase in the UAR: hazard ratio (HR) (95%CI): 1.186 (1.067–1.319); <i>P</i> = 0.002] and ICU mortality [per SD increase in the UAR: HR (95%CI): 1.190 (1.068–1.327); <i>P</i> = 0.002]. Restricted cubic spline regression analysis illustrated a linear relationship between UAR and the risks of in-hospital and ICU mortality.</p> Conclusions <p>Elevated UAR levels were strongly associated with all-cause mortality in critically ill patients with sepsis, suggesting their potential as predictors of poor outcomes. However, further studies are needed to validate our findings and investigate the underlying causal factors that could contribute to sepsis prevention and treatment.</p>

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Association between serum uric acid to albumin ratio and all-cause mortality in critically ill patients with sepsis: a retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月15日

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  • Jinhui Zhang,
  • Yang Liang,
  • Chao Song,
  • Zhenkui Hu

摘要

Background

The serum uric acid to albumin ratio (UAR) is a recently recognized composite inflammatory biomarker that has not received sufficient attention in relation to sepsis. This study aimed to investigate the association between UAR and the risk of all-cause mortality in critically ill patients with sepsis.

Methods

We conducted an analysis using a retrospective database of sepsis patients who were admitted to the Affiliated Hospital of Jiangsu University between January 2015 and November 2023. The patients were divided into four groups based on UAR quartiles. The primary outcome was in-hospital all-cause mortality. The Kaplan-Meier curve and log-rank tests were used to evaluate all-cause mortality among the four groups. Cox proportional hazards regression analysis and restricted cubic splines were performed to examine the association between UAR and clinical outcomes in patients with sepsis. Subgroup analyses were conducted to evaluate the impact of other variables on the relationship between UAR and all-cause mortality.

Results

A total of 1123 patients (63.0% males) were included in this study. The in-hospital and intensive care unit (ICU) mortality rates were 33.9% and 31.7%, respectively. There was a significant association between higher UAR levels and an increased cumulative incidence of 30-/60-day mortality (log-rank test, P < 0.001). Cox proportional hazards regression analysis demonstrated that the UAR was independently associated with a higher risk of in-hospital mortality [per SD increase in the UAR: hazard ratio (HR) (95%CI): 1.186 (1.067–1.319); P = 0.002] and ICU mortality [per SD increase in the UAR: HR (95%CI): 1.190 (1.068–1.327); P = 0.002]. Restricted cubic spline regression analysis illustrated a linear relationship between UAR and the risks of in-hospital and ICU mortality.

Conclusions

Elevated UAR levels were strongly associated with all-cause mortality in critically ill patients with sepsis, suggesting their potential as predictors of poor outcomes. However, further studies are needed to validate our findings and investigate the underlying causal factors that could contribute to sepsis prevention and treatment.