Abstract
BACKGROUND/OBJECTIVES: This study aimed to exploratory evaluate the association between fibrosis-4 index, albumin-bilirubin score, and neutrophil-lymphocyte ratio (FAN) sepsis (FANs) score, a sepsis score derived from fibrosis-4 index, albumin-bilirubin score, and neutrophil-lymphocyte ratio, and the prognosis of patients with poor performance status (PS) and sepsis associated with urinary tract stone obstruction. METHODS: We identified 56 patients with PS of 3 or 4 who were admitted to Kishiwada Tokushukai Hospital between April 2019 and March 2025 for septic shock due to obstructive pyelonephritis caused by a urinary tract stone. Patient information was collected retrospectively, and the association between prognosis and FANs score was evaluated. RESULTS: Patient characteristics were evaluated separately for each score group. Although differences were observed in the use of vasopressors, mean arterial pressure, procalcitonin, platelet counts, C-reactive protein, serum creatinine, and sequential organ failure assessment (SOFA) scores (p=0.04, p=0.01, p<0.01, p<0.01, p=0.01, p<0.01, and p<0.01, respectively), there were no other significant differences between the two groups. An increase in the FANs score was associated with increased mortality (p<0.01). Receiver operating characteristic (ROC) curve analysis showed that the FANs score had predictive ability equivalent to the SOFA score for in-hospital, one-year, and overall mortality. CONCLUSIONS: The FANs score may be associated with the prognosis of patients with poor PS and sepsis due to urinary tract stones.