Comparison of C-reactive protein/albumin ratio and neutrophil/lymphocyte ratio with conventional biomarkers for predicting septic shock in pediatric sepsis

Description

Zheng and colleagues test two ratios calculable from routine blood tests as warning signs that a child's sepsis is tipping into septic shock, in 2026 pediatric critical care research. The ratios combine C-reactive protein with albumin, and neutrophils with lymphocytes, both reflecting how inflammation and immune balance shift. The retrospective study covered 174 hospitalized children between June 2022 and November 2025: 123 with sepsis and 51 with septic shock under the 2024 Phoenix criteria. Blood was drawn within 24 hours of admission.

Both ratios ran significantly higher in the shock group than in the sepsis group at admission. Regression analysis confirmed each as an independent factor associated with shock, with the protein ratio carrying an odds ratio of 2.893 in the fitted model. Combined, the two ratios discriminated better than either alone, reaching an accuracy score of 0.802 with sensitivity of 74.50 percent and specificity of 74.80 percent across the cohort. Zheng proposes the pair as a cheap early triage aid.

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Source: https://europepmc.org/articles/PMC13374251