The relationship between hematocrit and serum albumin levels difference and mortality in elderly sepsis patients in intensive care units—a retrospective study based on two large database
Abstract Background Sepsis still threatens the lives of more than 300 million patients annually and elderly patients with sepsis usually have a more complicated condition and a worse prognosis. Existing studies have shown that both Hematocrit (HCT) and albumin (ALB) can be used as potential predicto...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-022-07609-7 |
| _version_ | 1828260033479049216 |
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| author | Zichen Wang Luming Zhang Shaojin Li Fengshuo Xu Didi Han Hao Wang Tao Huang Haiyan Yin Jun Lyu |
| author_facet | Zichen Wang Luming Zhang Shaojin Li Fengshuo Xu Didi Han Hao Wang Tao Huang Haiyan Yin Jun Lyu |
| author_sort | Zichen Wang |
| collection | DOAJ |
| description | Abstract Background Sepsis still threatens the lives of more than 300 million patients annually and elderly patients with sepsis usually have a more complicated condition and a worse prognosis. Existing studies have shown that both Hematocrit (HCT) and albumin (ALB) can be used as potential predictors of sepsis, and their difference HCT-ALB has a significant capacity to diagnose infectious diseases. Currently, there is no relevant research on the relationship between HCT-ALB and the prognosis of elderly sepsis patients. Therefore, this study aims to explore the association between HCT-ALB and mortality in elderly patients with sepsis. Methods This study was a multi-center retrospective study based on the Medical Information Mart for Intensive Care (MIMIC-IV) database and the eICU Collaborative Research Database (eICU-CRD) in elderly patients with sepsis. The optimal HCT-ALB cut-off point for ICU mortality was calculated by the Youden Index based on the eICU-CRD dataset, and multivariate logistic regressions were conducted to explore the association between HCT-ALB and ICU/hospital mortality in the two databases. Subgroup analyses were performed for different parameters and comorbidity status. Results The number of 16,127 and 3043 elderly sepsis patients were selected from two large intensive care databases (eICU-CRD and MIMIC-IV, respectively) in this study. Depending on the optimal cut-off point, patients in both eICU-CRD and MIMIC-IV were independently divided into low HCT-ALB (< 6.7) and high HCT-ALB (≥ 6.7) groups. The odds ratio (95%confidence interval) [OR (95CI%)] of the high HCT-ALB group were 1.50 (1.36,1.65) and 1.71 (1.58,1.87) for ICU and hospital mortality in the eICU-CRD database after multivariable adjustment. Similar trends in the ICU and hospital mortality [OR (95%CI) 1.41 (1.15,1.72) and 1.27 (1.07,1.51)] were observed in MIMIC-IV database. Subgroup analysis showed an interaction effect with SOFA score in the eICU-CRD database however not in MIMIC-IV dataset. Conclusions High HCT-ALB (≥ 6.7) is associated with 1.41 and 1.27 times ICU and hospital mortality risk in elderly patients with sepsis. HCT-ALB is simple and easy to obtain and is a promising clinical predictor of early risk stratification for elderly sepsis patients in ICU. |
| first_indexed | 2024-04-13T03:18:01Z |
| format | Article |
| id | doaj.art-dbff791d93d14ba69ed1b04070ae50d1 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-13T03:18:01Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-dbff791d93d14ba69ed1b04070ae50d12022-12-22T03:04:52ZengBMCBMC Infectious Diseases1471-23342022-07-0122111110.1186/s12879-022-07609-7The relationship between hematocrit and serum albumin levels difference and mortality in elderly sepsis patients in intensive care units—a retrospective study based on two large databaseZichen Wang0Luming Zhang1Shaojin Li2Fengshuo Xu3Didi Han4Hao Wang5Tao Huang6Haiyan Yin7Jun Lyu8Department of Intensive Care Unit, The First Affiliated Hospital of Jinan UniversityDepartment of Intensive Care Unit, The First Affiliated Hospital of Jinan UniversityDepartment of Orthopaedics, The First Affiliated Hospital of Jinan UniversityDepartment of Clinical Research, The First Affiliated Hospital of Jinan UniversityDepartment of Clinical Research, The First Affiliated Hospital of Jinan UniversityDepartment of Statistics, Iowa State UniversityDepartment of Clinical Research, The First Affiliated Hospital of Jinan UniversityDepartment of Intensive Care Unit, The First Affiliated Hospital of Jinan UniversityDepartment of Clinical Research, The First Affiliated Hospital of Jinan UniversityAbstract Background Sepsis still threatens the lives of more than 300 million patients annually and elderly patients with sepsis usually have a more complicated condition and a worse prognosis. Existing studies have shown that both Hematocrit (HCT) and albumin (ALB) can be used as potential predictors of sepsis, and their difference HCT-ALB has a significant capacity to diagnose infectious diseases. Currently, there is no relevant research on the relationship between HCT-ALB and the prognosis of elderly sepsis patients. Therefore, this study aims to explore the association between HCT-ALB and mortality in elderly patients with sepsis. Methods This study was a multi-center retrospective study based on the Medical Information Mart for Intensive Care (MIMIC-IV) database and the eICU Collaborative Research Database (eICU-CRD) in elderly patients with sepsis. The optimal HCT-ALB cut-off point for ICU mortality was calculated by the Youden Index based on the eICU-CRD dataset, and multivariate logistic regressions were conducted to explore the association between HCT-ALB and ICU/hospital mortality in the two databases. Subgroup analyses were performed for different parameters and comorbidity status. Results The number of 16,127 and 3043 elderly sepsis patients were selected from two large intensive care databases (eICU-CRD and MIMIC-IV, respectively) in this study. Depending on the optimal cut-off point, patients in both eICU-CRD and MIMIC-IV were independently divided into low HCT-ALB (< 6.7) and high HCT-ALB (≥ 6.7) groups. The odds ratio (95%confidence interval) [OR (95CI%)] of the high HCT-ALB group were 1.50 (1.36,1.65) and 1.71 (1.58,1.87) for ICU and hospital mortality in the eICU-CRD database after multivariable adjustment. Similar trends in the ICU and hospital mortality [OR (95%CI) 1.41 (1.15,1.72) and 1.27 (1.07,1.51)] were observed in MIMIC-IV database. Subgroup analysis showed an interaction effect with SOFA score in the eICU-CRD database however not in MIMIC-IV dataset. Conclusions High HCT-ALB (≥ 6.7) is associated with 1.41 and 1.27 times ICU and hospital mortality risk in elderly patients with sepsis. HCT-ALB is simple and easy to obtain and is a promising clinical predictor of early risk stratification for elderly sepsis patients in ICU.https://doi.org/10.1186/s12879-022-07609-7SepsisElderlyHCT-ALBMortalityMulti-center |
| spellingShingle | Zichen Wang Luming Zhang Shaojin Li Fengshuo Xu Didi Han Hao Wang Tao Huang Haiyan Yin Jun Lyu The relationship between hematocrit and serum albumin levels difference and mortality in elderly sepsis patients in intensive care units—a retrospective study based on two large database BMC Infectious Diseases Sepsis Elderly HCT-ALB Mortality Multi-center |
| title | The relationship between hematocrit and serum albumin levels difference and mortality in elderly sepsis patients in intensive care units—a retrospective study based on two large database |
| title_full | The relationship between hematocrit and serum albumin levels difference and mortality in elderly sepsis patients in intensive care units—a retrospective study based on two large database |
| title_fullStr | The relationship between hematocrit and serum albumin levels difference and mortality in elderly sepsis patients in intensive care units—a retrospective study based on two large database |
| title_full_unstemmed | The relationship between hematocrit and serum albumin levels difference and mortality in elderly sepsis patients in intensive care units—a retrospective study based on two large database |
| title_short | The relationship between hematocrit and serum albumin levels difference and mortality in elderly sepsis patients in intensive care units—a retrospective study based on two large database |
| title_sort | relationship between hematocrit and serum albumin levels difference and mortality in elderly sepsis patients in intensive care units a retrospective study based on two large database |
| topic | Sepsis Elderly HCT-ALB Mortality Multi-center |
| url | https://doi.org/10.1186/s12879-022-07609-7 |
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