Fibrinogen to Albumin Ratio and 28-Day Mortality in sepsis-associated acute kidney injury: a retrospective cohort study

Abstract Background:To explore the correlation between the Fibrinogen to Albumin Ratio (FAR) and the 28-day mortality rate in patients with sepsis-associated acute kidney injury (SA-AKI) within an intensive care unit (ICU) setting, with an emphasis on the prognostic value of FAR. Methods: A retrospective cohort study was conducted on SA-AKI patients represented in the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Multivariable Cox regression analysis was used to determine adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analysis, survival curves, and curve fitting were employed to evaluate the relationship between FAR and prognosis in SA-AKI patients. Results: In this study, a total of 1297 participants were included. The participants had a mean age of 61.4 ± 14.1 years and a mean FAR of 1.155 (range 0.09 to 7.84). After controlling for variables, the Hazard Ratio (HR) for 28-day mortality in Tertile 3 (FAR > 1.21) was 0.68 (HR: 0.68, 95% CI: 0.53–0.87, p = 0.002) compared to Tertile 1 (FAR < 0.63). The results for 90-day mortality and in-hospital mortality were Similar. Kaplan-Meier (KM) analysis indicated lower mortality rates at 28 days and 90 days in the group with higher FAR. Conclusion: The findings underscore the prognostic significance of FAR in SA-AKI, suggesting that a lower FAR is linked to increased mortality risks at 28 days, 90 days, and during hospitalization.