Association between alkaline phosphatase to albumin ratio and 28-day mortality among geriatric patients with sepsis: a cohort study

The primary objective of our study was to investigate the relationship between alkaline phosphatase to albumin ratio (APAR) and the risk of 28-day mortality in geriatric patients with sepsis. This was a retrospective cohort study of patients with sepsis in the eICU Collaborative Research Database (eICU-CRD) from 208 distinct ICUs across the United States between 2014 and 2015 that explored all-cause mortality within 28 days after ICU admission. The association between APAR and 28-day mortality was assessed through multivariate logistic regression. We explored the non-linear connection between APAR and 28-day mortality in septic patients using a generalized additive model and smooth curve fitting. Our study uncovered that APAR serves as an independent risk factor for 28-day mortality in geriatric patients with sepsis. Furthermore, we identified inflection points in APAR at 4.2. These findings emphasize a non-linear relationship between APAR and the risk of 28-day mortality in geriatric patients with sepsis. In the context of a period of rapidly increasing mortality with an APAR of less than 4.2, the prognosis of elderly patients with sepsis may be optimized through a monitoring strategy for this indicator and timely implementation of appropriate medical intervention.