Hyperuricaemia ups death risk in ICU patients with sepsis

In intensive care unit (ICU) patients with sepsis, hyperuricaemia correlates with significantly higher all-cause mortality and acute kidney injury (AKI), a recent study has found.

Drawing from the Intensive Care Medical Information Database III, containing data from over 50,000 ICU patients in the US, the researchers retrospectively assessed 954 patients, of whom 345 had hyperuricaemia while 609 had normal serum uric acid levels.

The outcomes of interest were 90-day and 30-day mortality, AKI, and hospital mortality, the rates for which were compared between groups after propensity score matching, which left 225 patients in each group.

In the matched cohort, 107 patients in the hyperuricaemia group died by 90 days, as compared to 82 patients in the normal serum uric acid group; the corresponding rates were 23.8 percent and 18.2 percent (p=0.022). The same was true for AKI (19.1 percent vs 14.7 percent; p=0.046) and 30-day mortality (21.6 percent vs 16 percent; p=0.019).

Multivariate Cox regression analysis further verified the significant role of hyperuricaemia in independently increasing the risk of 90-day mortality (hazard ratio [HR], 1.648, 95 percent confidence interval [CI], 1.215–2.234; p=0.006) and AKI (HR, 1.773, 95 percent CI, 1.107–2.841; p=0.017).

“Our findings need to be further confirmed by large multicentre prospective studies, and additional studies need to be performed to identify the specific mechanism by which hyperuricemia affects the long-term prognosis of patients with sepsis,” the researchers said.