Value of serum uric acid/creatinine ratio in prognostic assessment of patients with bowel obstruction sepsis

Yang Jie; Guo Shubin; Ji Wenqing; Liu Xiaomeng; Li Daorong; Xie Xuefei; Wang Junyu

doi:10.11986/j.issn.1673-873X.2025.07.06

Abstract：Objective To explore the clinical value of the serum uric acid/creatinine(UA/Cr)ratio in the prognostic assessment of patients with bowel obstruction sepsis,with the aim of providing a reference for early identification of high-risk patients to improve clinical outcomes.Methods A total of 152 patients with bowel obstruction sepsis treated at Beijing Chaoyang Hospital from May 2021 to June 2024 were selected as study participants.Based on their prognosis at 28 days after admission,they were assigned to the good prognosis group(n=117)and the poor prognosis group(n=35).Serum uric UA and Cr levels were measured using an enzyme colorimetric method,and the UA/Cr ratio was calculated.Receiver operating characteristic(ROC)curve analysis was used to assess the predictive efficacy of the serum UA/Cr ratio on the prognosis of the patients.Multi-factor logistic stepwise regression analysis was used to determine the factors influencing the prognosis of bowel obstruction sepsis pa-tients.Results The serum UA,Cr levels,and UA/Cr ratio of patients in the poor prognosis group were higher than those in the good prognosis group,with statistically significant differences(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)for the serum UA/Cr ratio in predicting the prognosis of bowel obstruction sepsis patients was 0.923(95％CI:0.883-0.973),which was significantly higher than the AUC for UA alone(0.812,95％CI:0.767-0.862)and Cr alone(0.754,95％CI:0.704-0.799;Z=8.769,10.214,both P＜0.001).There were no statistically significant differences between the two groups in terms of gender,age,body mass index,hypertension,coronary heart disease,smoking history,mechanical ventilation usage,PaO2,white blood cell count,lymphocyte count,neutrophil count,or hemoglobin levels(P＞0.05).The poor prognosis group had a higher pro-portion of diabetes,higher acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores,sequential organ failure as-sessment(SOFA)scores,C-reactive protein(CRP)levels,and procalcitonin(PCT)levels,and lower platelet count and albu-min levels compared to the good prognosis group,with all differences being statistically significant(P＜0.05).Multi-factor lo-gistic stepwise regression analysis indicated that APACHE Ⅱ score(OR=2.385,95％CI:1.452-3.915),UA/Cr(OR=3.401.95％CI:1.893-6.111),and albumin(OR=0.401,95％CI:0.222-0.724)were independent factors influencing poor prognosis in bowel obstruction sepsis patients(P＜0.05).Conclusion Elevated serum UA/Cr ratio is an independent risk factor for poor prognosis in bowel obstruction sepsis patients.Its predictive value for prognosis is superior to that of UA or Cr alone.Clinical monitoring of the UA/Cr ratio is conducive to early identification of high-risk patients and enables targeted interventions to promote their prognosis.