Clinical Value of the Serum Procalcitonin to Albumin Ratio in the Diagnosis and Prognosis of Sepsis-Associated ARDS Patients: A Retrospective Study.

Objective: To evaluate the diagnostic and prognostic value of the Serum Procalcitonin (PCT) to Albumin (ALB) ratio in sepsis-associated ARDS patients.

Methods: We conducted a retrospective study including 349 septic patients (159 and 190 with and without ARDS, respectively). The serum PCT/ALB ratio was measured at admission, and participants' 28-day mortality and Sequential Organ Failure Assessment (SOFA) scores were compared.

Results: Compared to patients without sepsis-associated ARDS, sepsis-associated ARDS patients had a higher PCT/ALB ratio (P<0.001). Among sepsis-associated ARDS patients, non-survivors had a significantly higher PCT/ALB ratio than survivors (P<0.05). The AUC of the PCT/ALB ratio associated with the 28-day mortality in sepsis-associated ARDS patients on admission day was 0.62 (95% CI [0.54-0.69], P<0.001). In assessing the 28-day mortality in sepsis-associated ARDS patients, the AUC of the PCT/ALB ratio in combination with the oxygenation index and SOFA score rose from 0.62 to 0.78 (95% CI: 0.70-0.84; P<0.001). Moreover, survival analysis revealed that sepsis-associated ARDS patients with a higher PCT/ALB ratio (≥2.03 μg/g) had a significantly poorer prognosis than those with a low ratio (<2.03 μg/g).

Conclusions: The PCT/ALB ratio is a potential biomarker for the diagnosis and prognosis of sepsis-associated ARDS patients.