The Prognostic Significance of Serum Uric Acid in SepsiA Comparative Study on Adult Patients

Background and aims: Sepsis is an oxidative state characterized by a dysregulated immune response to infection, causing multiorgan dysfunction. Uric acid, with its dual role in oxidation and antioxidation, may influence sepsis severity and outcomes. This study aimed to investigate the association between hyperuricemia and the severity and clinical outcomes in sepsis patients. Patients and methods: A prospective, observational cohort study was conducted in medical intensive care units (ICUs) from February 2023 to May 2024. A total of 224 patients aged ≥18 years with clinical suspicion of sepsis and sequential organ failure assessment (SOFA) score ≥2 on admission were enrolled. The patients were divided into hyperuricemic (serum uric acid ≥7 mg/dL) and normouricemic groups. Results: One hundred and twelve patients were enrolled in each group. The hyperuricemic group had significantly higher SOFA (7 vs 5, p = 0.001) and Acute Physiology and Chronic Health Evaluation (APACHE) II (33.5 vs 18, p = 0.001) scores. They also had higher rates of shock at admission (23.2% vs 12%, p = 0.036), acute kidney injury (AKI) (89.3% vs 58%, p = 0.001), need for hemodialysis (42.9% vs 23.2%, p = 0.002), and longer ICU stays (6 vs 4 days, p = 0.003). Mortality was higher in the hyperuricemic group (25% vs 13.4%, p = 0.052). Kaplan−Meier analysis revealed significantly lower survival rates in hyperuricemic patients (log-rank test, p = 0.022). Multivariate analysis identified hyperuricemia as an independent predictor of poor outcomes. Conclusion: Hyperuricemia is associated with increased severity of illness and a higher incidence of AKI, prolonged ICU stays, and increased mortality in sepsis.