Hubungan Antara Kadar Glutamin dalam Darah dengan Tingkat Mortalitas pada Pasien Sepsis di RS Adam Malik Medan

Abstract

Sepsis remains a leading cause of morbidity and mortality in critically ill patients. Glutamine, a conditionally essential amino acid, plays an important role in immune function, intestinal integrity, and inflammatory response. This study aimed to analyze the association between serum glutamine levels and mortality in sepsis patients. A cross-sectional study with a retrospective design was conducted on 36 sepsis patients admitted to H. Adam Malik General Hospital Medan between April and June 2025. Data were collected from medical records, including demographic characteristics, antibiotic therapy, body mass index (BMI), Charlson Comorbidity Index (CCI), and serum glutamine levels. Statistical analysis was performed using bivariate tests, logistic regression, and ROC curve analysis. The results showed that the mean serum glutamine level was 3.8 ng/mL, with an optimal cut-off value of 3.9 ng/mL (AUC 0.72; p<0.05). Patients with serum glutamine levels <3.9 ng/mL had a significantly higher risk of mortality compared to those with levels ≥3.9 ng/mL (OR 5.2; 95% CI: 1.1–24.6; p<0.05). Most patients had normal BMI and low-to-moderate CCI scores, with the respiratory tract being the most common source of infection. In conclusion, lower serum glutamine levels are significantly associated with increased mortality in sepsis patients. This finding highlights the potential role of serum glutamine measurement as a simple prognostic biomarker in the clinical evaluation of sepsis, as well as its relevance in guiding preventive and nutritional management strategies.