Review Question - QID 219818

You are consulted on a 64-year-old male with a past medical history of chronic obstructive pulmonary disease, diabetes, intravenous drug use, and chronic kidney disease who was admitted to the intensive care unit (ICU) yesterday for sepsis believed to be secondary to volar forearm cellulitis. The ICU provider noted the patient deteriorated overnight, requiring intubation, and has since required norepinephrine. On examination, there is poorly demarcated erythema on the volar forearm with significant edema and bullae formation. The patient is subsequently brought to the operating room for incision and debridement, where infection, skin, and underlying fascia are excised, with a defect measuring 20 by 45 centimeters. Which of the following is most predictive of mortality in this patient?