الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Sepsis is a leading cause of mortality and critical illness worldwide. Sepsis has been defined as an invasion of microorganisms or their toxins into the bloodstream, together with the host response to this invasion. There is a continuum of severity ranging from sepsis to septic shock. Septic shock is a major healthcare problem, affecting millions of people around the world each year, and is increasing in incidence. Septic shock is defined as “A subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with greater mortality than with sepsis alone”. It can be identified clinically by hypotension requiring vasopressors to maintain mean arterial blood pressure ≥ 65 mmHg and serum lactate level >2 mmol/L after adequate fluid resuscitation.
The overall decreases in in-hospital sepsis mortality probably due to improvement in ICU care are encouraging. However, given that the overall incidence of sepsis is seemingly increasing at greater rates, overall mortality is not significantly improving, demonstrating the continuing magnitude of the challenge. So, a standardized tool for mortality risk prediction in critically ill septic patients is needed to ensure the optimal use of healthcare resources.
The aim of the present study was to compare between CRP and Cl-: Na+ ratio as indicators of mortality in patients with septic shock. The study was carried out on 90 adult patients of both sex, admitted to the Intensive Care Unit (ICU) in Alexandria Armed Forces Hospital with diagnosis of septic shock and managed according to Surviving Sepsis Campaign guidelines. They were classified into three groups according to their Cl-: Na+ ratio on admission; group I (low Cl-: Na+ ratio), group II (normal Cl-: Na+ ratio) and group III (high Cl-: Na+ ratio).
group I (low Cl-: Na+ ratio) included 28 patients (31.1 %), group II (normal Cl-: Na+ ratio) included 36 patients (40%) while group III (high Cl-: Na+ ratio) included 26 patients (28.9%).
The mean age in group I and II (58.7 ± 7.5 years and 58.2 ± 8.0 years respectively) was higher than that in group III with no statistical significant difference. group III had more male patients (57.7%) with no statistical significant difference.