Articles Tập 67 Số CĐ1-NCKH 27/01/2026

THE VALUE OF THE BLOOD PROCALCITONIN-TO-ALBUMIN RATIO IN PREDICTING 28-DAY MORTALITY IN SEPSIS AT THONG NHAT HOSPITAL

Hoang Van Quang1,2,3,4, Nguyen Duy Cuong2,4, Pham Thi Thanh Thuy2,4
1 Faculty of Medicine, Nguyen Tat Thanh University
2 Thong Nhat Hospital
3 Khoa Y, Trường Đại học Nguyễn Tất Thành
4 Bệnh viện Thống Nhất
DOI: 10.52163/yhc.v67iCD1.4244
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Keywords
Procalcitonin, albumin, mortality, sepsis.
Abstract

Objective: To investigate the association between the procalcitonin-to-albumin ratio and disease severity scores (SOFA, APACHE II, lactate) and to assess its prognostic value for 28-day mortality in septic patients.

Methods: A prospective cohort study was conducted from August 2023 to August 2025, including 196 patients admitted to the Intensive Care Unit of Thong Nhat Hospital. Procalcitonin and albumin were measured within 24 hours after sepsis diagnosis to calculate procalcitonin-to-albumin ratio.

Results: The median age was 70 years, and 48% were male. The respiratory tract was the primary source in 45%, and blood culture positivity was 26%. Non-survivors had higher SOFA, APACHE II, procalcitonin, and lactate, but lower albumin and pH. Procalcitonin-to-albumin ratio correlated positively with lactate (r = 0.75), SOFA (r = 0.78), and APACHE II (r = 0.82), all p < 0.001. In multivariate analysis, procalcitonin-to-albumin ratio independently predicted 28-day mortality (OR = 1.339, 95% CI: 1.190-1.508, p < 0.001). The AUC for mortality prediction was 0.85 (cutoff 4.05; sensitivity 94.5%; specificity 60.9%).

Conclusion: Procalcitonin-to-albumin ratio reflects both inflammation and malnutrition, correlates with sepsis severity, and provides strong prognostic value for 28-day mortality. It is a simple, feasible marker that may be widely applied in clinical practice.

References
[1]
Via L.L, Sangiorgio G et al. The global burden of sepsis and septic shock. Epidemiologia (Basel), 2024, 25, 5 (3): 456-478. doi: 10.3390/epidemiologia5030032. Google Scholar
[2]
Singer M, Deutschman C.S et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA, 2016, 315 (8): 801-810. doi:10.1001/jama.2016.0287. Google Scholar
[3]
Hasa V.S, Sahoo B et al. Procalcitonin -to-albumin ratio vs. C-reactive protein-to-albumin ratio in predicting sepsis and its severity in children: A prospective observational study. Cureus, 2025,17 (4): e81935. doi: 10.7759/cureus.81935. Google Scholar
[4]
Sang-Min Kim, Seung-Mok Ryoo et al. Early mortality stratification with serum albumin and the sequential organ failure assessment score at emergency department admission in septic shock patients. Life (Basel), 2024, 14 (10): 1257. doi: 10.3390/life14101257. Google Scholar
[5]
Zhang H, Wang X et al. Comparison of procalcitonin and high sensitivity C-reactive protein for the diagnosis of sepsis and septic shock in the oldest old patients. BMC Geriatrics, 2017, 17 (1): 173. doi: 10.1186/s12877-017-0566-5. Google Scholar
[6]
Li F, Ye Z et al. Early lactate/albumin and procalcitonin /albumin ratios as predictors of 28-day mortality in ICU-admitted sepsis patients: A retrospective cohort study. Med Sci Monit, 2023, 29: e940654-1-e940654-16. doi: 10.12659/MSM.940654. Google Scholar
[7]
Chen L, Wu X et al. The procalcitonin to albumin ratio predicts mortality in patients with acute kidney injury caused by abdominal infection-evoked sepsis. Front Nutr, 2021, 8: 584461. doi: 10.3389/fnut.2021.584461. Google Scholar
[8]
Parulekar L, Sardar A.S. A comparative study of procalcitonin - albumin ratio with other biomarkers of sepsis as a predictor of morbidity and mortality in patients of sepsis. Indian J Crit Care Med, 2024, 28 (Suppl 1): S58-S59. doi: 10.5005/jaypee-journals-10071-24667.21. Google Scholar
[9]
Altuğ E, Can D et al. An investigation of procalcitonin/albumin ratio as a predictor of mortality in patients with sepsis. Annals of Clinical and Analytical Medicine, 2024, 15 (06): 444-448. doi: 10.4328/ACAM.22203. Google Scholar
[10]
Jian-Chang Lin, Zhao-Hong Chen et al. Elevated serum procalcitonin predicts Gram-negative bloodstream infections in patients with burns. Burns, 2020, 46, (1): 182-189. doi: 10.1016/j.burns.2019.04.010. Google Scholar
[11]
Manas S.A.A et al. Procalcitonin to albumin ratio as a predictor of intensive care unit mortality in sepsis. Journal of Critical and Intensive Care, 2024, 15 (1): 23-29. doi: 10.14744/dcybd.2024.3689. Google Scholar