The role of serum uric acid in severe sepsis among patients admitted to Internal Medicine

Background: High serum uric acid(SUA) levels are associated tocardiovascular diseases and death. We evaluated the role of SUA insepsis.Methods:in 2015 we enrolled all septic patients admitted to our de-partment. Age, sex, hypertension, diabetes,cancer, CHF, COPD, smoking,blood gas analysis, SUA, days of hospitalization, death or UTI transferand SOFA were collected. Relationships were explored with bivariatecorrelation. Continuous variables were compared with t-test, dichoto-mous with chi-squared test. Univariate model was used to control for covariates. Analysis was performed with SPSS 13.0 for Windows.Results: 71 patients (M: 49,3%), mean age 76,8 (±15,4) years wereenrolled. Hypertension affected 72,9%, diabetes 28,2%, cancer 25,4%,CHF 43,7%, COPD 12,7% of subjects. Mean SUA was 6,49 (±0,41)mg/dL, mean SOFA 4,34 (±0,24), admission lasted 11,65 (±0,68)days. Death or UTI transfer happened in 32,4%. SUA was associatedto SOFA (p<0,05) and death or UTI transfer (p<0,001) at bivariate test.Patients who died or were transferred to UTI had higher SUA(7,68±5,07) than survivors (5,92±2,24; p<0,05). SUA and SOFA(r2=0,84; p<0,0001) had an exponential relationship. Univariate modeladopted SOFA as outcome,SUA as predictor, age, sex, hypertension,smoking, diabetes, cancer, CHF and COPD as covariates: SUA≥7.0 hadsignificantly (p=0.01) higher SOFA (5,13±0,72) than patients with SUAbetween 4.0-6.9 (3,56±0,86) and SUA <4.0 (3,40±0.86).Conclusions:Increased SUA is associated to complexity and severity in sepsis. Subjects with hyperuricemia had higher mortality and SOFA.Larger studies are required to clarify this observation