Association between trajectory patterns of urea-to-creatinine ratio within 7 days after admission and prognosis in patients with sepsis

Association between trajectory patterns of urea-to-creatinine ratio within 7 days after admission and prognosis in patients with sepsis. Download PDF Abstract Sepsis is a life-threatening syndrome characterized by substantial clinical heterogeneity. The urea-to-creatinine ratio (UCR) is a readily available biomarker reflecting systemic metabolic stress and renal handling; however, the prognostic value of its dynamic trajectories in sepsis remains unclear.

This study aimed to identify UCR trajectory phenotypes in patients with sepsis using longitudinal data analysis and to investigate their associations with 30-day all-cause mortality. This retrospective cohort study was conducted using data from the MIMIC-IV database. A total of 7145 patients who met the Sepsis-3 diagnostic criteria were included.

Longitudinal UCR measurements within the first 7 days after ICU admission were analyzed using latent class growth mixture modeling (LCGMM) to identify distinct trajectory patterns. Kaplan–Meier survival analysis and multivariable Cox proportional hazards regression were performed to evaluate the associations between UCR trajectory phenotypes and 30-day all-cause mortality. Five distinct UCR trajectory classes were identified by LCGMM: Class 1 (low-to-high sharp increase, 2.9%), Class 2 (low-to-moderate gradual increase, 24.3%), Class 3 (persistently low stable, 55.6%), Class 4 (high-to-low rapid decline, 2.0%), and Class 5 (moderately high gradual decline, 15.1%).

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