Clinical and Therapeutic Insights into Sepsis: A Retrospective Observational Study of Inflammatory Markers, and Outcomes.

Introduction: Sepsis is a life-threatening condition caused by dysregulated host responses to infection, leading to organ failure and high mortality. Early recognition, especially in vulnerable populations, remains challenging due to variable presentations. Key biomarkers like CRP, procalcitonin, fibrinogen, and neutrophil-to-lymphocyte ratio (NLR) aid in diagnosis, monitoring, and prognosis. Rapid identification and targeted therapy are critical, particularly amid rising antimicrobial resistance. This study aims to analyze the relationship between early biomarker levels and patient outcomes, focusing on mortality risk prediction within the first week of hospitalization. Methods: A retrospective study of 198 sepsis patients hospitalized in Bucharest, Romania, between January and December 2024, analyzing inflammatory biomarkers at admission-T0, 48-72 h-T1, and one week-T2, to identify predictors of clinical outcomes. Results: In patients under 65 years old, fibrinogen, CRP, and NLR significantly decreased from T0 to T2, especially in survivors. In contrast, patients over 65 years old showed less consistent biomarker changes, with higher mortality associated, with comorbidities such as heart failure and cancer. Overall, early reductions in inflammatory markers correlated with better outcomes, highlighting their prognostic value in sepsis management. Conclusions: In sepsis patients over 65 years old, a stable or rising neutrophil-to-lymphocyte ratio (NLR) and fibrinogen levels after the first week of hospitalization may indicate a poor prognosis, whereas decreasing levels suggest a better chance of survival.