Urea / Albumin and CRP / Albumin Ratios as Predictors of Outcomes in Pediatric Sepsis - A Comparative Analysis of Mortality Prediction Using the PIM-3 Score.

Pediatric sepsis requires early risk identification to enable timely intervention, optimize resource allocation, and improve survival outcomes. This study aims to assess the validity of simple biomarkers, such as the Urea / Albumin ratio and the CRP / Albumin ratio, in predicting outcomes and to compare their performance with the Pediatric Index of Mortality-3 (PIM-3) score for predicting mortality. The cohort study was conducted at a Pediatric Intensive Care Unit (PICU) and included children aged 1 mo to 12 y with sepsis. For predicting mortality, the CRP / Albumin ratio (cut-off 21.5) had an Area Under the Curve (AUC) of 0.684, while the Urea / Albumin ratio (cut-off 8.28) and PIM-3 score showed an AUC of 0.852 and 0.830, respectively. The Urea / Albumin ratio showed comparable performance with the PIM-3 score. Additionally, the predictive performance for both ratios was modest for mechanical ventilation and acceptable for inotropes. A higher CRP / Albumin ratio was associated with longer PICU stays (≥5 d).