Can Microalbuminuria Predict the Outcome (Mortality) in Critically ill Patients? A Hospital-based, Prospective, Observational Study

Background: Complex scores, such as Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, are highly reliable methods of to predict the mortality in critically ill patients. However, due to their complex nature intense resource requirements, their utility is limited in resource-poor settings like India. Hence, low-cost reliable markers like microalbuminuria can be utilized in such situations. Hence, the present study intends to assess the role of microalbuminuria in predicting the mortality among critically ill patients. Materials and Methods: The study was a prospective observational study, conducted in a medical-surgical intensive care unit (ICU) of a private tertiary care teaching hospital. A total of 50 adult patients (>18 years) with a stay in the ICU for more than 24 h were included. For disease severity scoring, urinary microalbumin will be measured using the immunoturbidimetric method with an albumin creatinine ratio cutoff of 30-300 mg/L. Results: The mean microalbumin level was 25.39 g/dl higher in people who met with mortality, compared to people who survived (95% confidence interval [CI]: 43.57-94.37, P < 0.463), which was statistically not significant. The mean microalbumin level was 25.39 g/dl higher in people who met with mortality, compared to people who survived (95% CI: 43.57-94.37, P = 0.463), which was statistically not significant. The area under receiver operating characteristic curve for microalbumin in predicting mortality was 0.59 (95% CI: 0.41-0.772, P = 0.398) and was very close to the null value of 0.5% and 95% CI included the null value of 0.5. Conclusions: To conclude, the findings reveal that microalbuminuria weakly correlated with the mortality of the ICU patients and that the APACHE II scores may be more reliable and accurate measure, though it employs cumbersome data collection methods and complex statistical analysis.