Albumin Level is Associated with Short-Term and Long-Term Outcomes in Sepsis Patients Admitted in the ICU: A Large Public Database Retrospective Research

Cao, Yan; Su, Yingjie; Guo, Cuirong; He, Lin; Ding, Ning

doi:10.2147/clep.s396247

Cited by 17 publications

(6 citation statements)

References 35 publications

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“…This retrospective study was performed on the basis of the data from the Medical Information Mart for Intensive Care IV(MIMIC-IV) database ( https://mimic.mit.edu/iv/ ). MIMIC-IV is a U.S. public database and contains the clinical information of critical ill patients admitted in intensive care unit (ICU) of Beth Israel Deaconess Medical Center of Boston between 2008 and 2019 15 – 17 . The corresponding author (N.D.) passed the Protecting Human Research Participants exam (No.32900964) and had the permission for utilizing the MIMIC-IV database.…”

Section: Methodsmentioning

confidence: 99%

The relationship between serum ferritin level and clinical outcomes in sepsis based on a large public database

Guo

et al. 2023

Sci Rep

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This study aimed to investigate the relationship between serum ferritin level and prognosis in sepsis. It also explored the potential prognostic value of serum ferritin for predicting outcomes in sepsis based on a large public database. Sepsis patients in MIMIC-IV database were included. Different models including crude model (adjusted for none), model I (adjusted for age and gender) and model II (adjusted for all potential confounders) were performed. Smooth fitting curves were constructed for exploring the relationships between serum ferritin and mortalities of 28-day, 90-day, 180-day and 1-year. Receiver operator characteristic (ROC) curve analysis was utilized for assessing the predictive value of serum ferritin. 1947 sepsis patients were included. The mortalities of 28-day, 90-day, 180-day and 1-year were 20.18% (n = 393), 28.35% (n = 552), 30.30% (n = 590) and 31.54% (n = 614), respectively. In Model II (adjusted for all potential confounders), for every 1000 ng/ml increment in serum ferritin, the values of OR in mortalities of in 28-day, 90-day, 180-day and 1-year were 1.13 (95% CI 1.07–1.19, P < 0.0001), 1.15 (95% CI 1.09–1.21, P < 0.0001), 1.16 (95% CI 1.10–1.22, P < 0.0001) and 1.17 (95% CI 1.10–1.23, P < 0.0001), respectively. The relationships between serum ferritin level and outcomes were non-linear. The areas under the ROC curve (AUC) of ferritin for predicting mortalities of 28-day, 90-day, 180-day and 1-year were 0.597 (95% CI 0.563–0.629), 0.593 (95% CI 0.564–0.621), 0.595 (95% CI 0.567–0.623) and 0.592 (95% CI 0.564–0.620), respectively. The non-linear relationships between serum ferritin and clinical outcomes in sepsis were found. Serum ferritin had a predictive value for short-term and long-term outcomes in sepsis.

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Section: Methodsmentioning

confidence: 99%

The relationship between serum ferritin level and clinical outcomes in sepsis based on a large public database

Guo

et al. 2023

Sci Rep

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“…Albumin supplementation might benefit septic patients with serum albumin <2.6 g/dL. 52 Additionally, based on the same MIMIC-IV database, the Yang Xu team reported that in sepsis patients, the RAR was found to be independently correlated with the risk of acute kidney injury (AKI). 27 Compared with the general population, patients with anemia and malnutrition are more prone to bacterial or viral infections due to weakened immune function and fragile immune homeostasis.…”

Section: Discussionmentioning

confidence: 99%

The Ratio of Red Blood Cell Distribution Width to Albumin as a Predictor for Rehospitalization Risk and Rehospitalization All-Cause Mortality in Middle-Aged and Elderly Survivors with Sepsis: An Ambispective ICU Cohort Study

Tan,

Li,

Huang

et al. 2024

JIR

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Objective To explore the relationship between red blood cell distribution width to albumin (RDW/ALB) ratio (RAR) and the risk of rehospitalization and rehospitalization all-cause mortality in middle-aged and elderly survivors with sepsis based on an ambispective longitudinal cohort from the Intensive Care Unit (ICU). Methods Between 2017 and 2022, 455 adults who survived the first-episode severe sepsis without recurrence for at least 3 months were included in this study. All participants were followed up every 4 weeks for 12 months. According to the tertiles of RAR, participants were divided into three groups: low-level (≤0.36, n = 152), moderate-level (0.37–0.44, n = 152), and high-level (≥0.45, n = 151). The relationship between RAR and the risk of rehospitalization and rehospitalization all-cause mortality was evaluated. Results Out of 455 participants, 156 experienced rehospitalization (34.3%), of which 44 (28.2%) died. Receiver operating characteristic (ROC) analysis showed that the RAR cut-off values for rehospitalization and rehospitalization all-cause mortality were 0.4251 and 0.4743, respectively. Multivariate Cox regression analysis indicated that the RAR was positively associated with rehospitalization ( P = 0.011) and all-cause mortality ( P = 0.006). Compared with the low-level, the high-level RAR presented a higher dose-dependent rehospitalization risk ( P = 0.02) and rehospitalization all-cause mortality ( P = 0.044). The stratified analysis displayed that compared to the low-level, with the RAR increasing by 1.0, the risk for rehospitalization increased 3.602-fold in aged <65 patients ( P = 0.002) and 1.721-fold in female patients ( P = 0.014). Kaplan–Meier survival analysis implied a significant positive association between the RAR and the cumulative incidence of rehospitalization and rehospitalization all-cause mortality (log-rank, all P < 0.001). Conclusion RAR has a reliable predictive value for the risk of rehospitalization and rehospitalization all-cause mortality in patients with sepsis. Consequently, monitoring RAR for at least 1 year after surviving sepsis in female patients aged <65 in clinical practice is critical.

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“…In recent years, an increasing number of researchers have found that inflammatory biomarkers, such as ALB [ 17 ], ferritin [ 6 ], Albumin/Fibrinogen [ 18 , 19 ], hematocrit [ 20 ], platelets [ 21 ], Red blood cell distribution width [ 22 ], systemic immune-inflammation index [ 23 ], Prognostic nutrition index [ 24 ], and urea nitrogen/albumin [ 25 ], etc. FAR holds potential as a prognostic indicator for predicting the outcome of sepsis patients.…”

Section: Discussionmentioning

confidence: 99%

“…Recent research indicates that hypoalbuminemia in sepsis patients is not primarily caused by suppressed liver synthesis, but rather by enhanced systemic clearance [ 31 ]. Studies indicate that serum albumin is an independent prognostic risk factor for sepsis patients [ 13 , 17 ]. Nevertheless, it is important to consider that serum albumin levels can be influenced by various factors, including nutritional status, hepatic and renal function, chronic inflammatory conditions, and other underlying medical conditions of the patients.…”

Section: Discussionmentioning

confidence: 99%

Association between ferritin to albumin ratio and 28-day mortality in patients with sepsis: a retrospective cohort study

Liu,

Liu

2023

Eur J Med Res

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Objectives The ratio of ferritin to albumin (FAR) has been proposed as a novel prognostic indicator for COVID-19. However, the role of FAR in predicting the all-cause mortality rate in patients with sepsis has not been evaluated. Therefore, the aim of this study is to elucidate the correlation between FAR and the 28-day all-cause mortality rate in patients with sepsis. Methods This study used data from the Medical Information Mart for Intensive Care IV database (v2.0) for a retrospective cohort analysis. The study focused on adult patients with sepsis who were admitted to the intensive care unit. The primary objective was to assess the predictive capability of FAR in determining the 28-day all-cause mortality rate among patients with sepsis. Results The study involved 1553 sepsis patients in total. Based on the survival status of sepsis patients within 28 days, they were divided into two groups: a survival group consisting of 973 patients, and a death group consisting of 580 patients. The results revealed a 28-day mortality rate of 37.35% among sepsis patients. The multivariable Cox regression analysis revealed that FAR was an independent predictor of the 28-day all-cause mortality rate in patients with sepsis (hazard ratio [HR]: 1.17–1.19; 95% confidence interval 1.11–1.26; P < 0.001). The FAR demonstrated a higher area under the curve (AUC) of 61.01% (95% confidence interval 58.07–63.96%), compared to serum ferritin (60.48%), serum albumin (55.56%), and SOFA score (56.97%). Receiver operating characteristic curve (ROC) analysis determined the optimal cutoff value for FAR as 364.2215. Kaplan–Meier analysis revealed a significant difference in the 28-day all-cause mortality rate between patients with FAR ≥ 364.2215 and those with FAR < 364.2215 (P < 0.001). Furthermore, subgroup analysis showed no significant interaction between FAR and each subgroup. Conclusions This study revealed a significant correlation between FAR and the 28-day mortality rate in patients with sepsis. Higher FAR values were strongly associated with increased mortality rates within 28 days.

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Albumin Level is Associated with Short-Term and Long-Term Outcomes in Sepsis Patients Admitted in the ICU: A Large Public Database Retrospective Research

Cited by 17 publications

References 35 publications

The relationship between serum ferritin level and clinical outcomes in sepsis based on a large public database

The relationship between serum ferritin level and clinical outcomes in sepsis based on a large public database

The Ratio of Red Blood Cell Distribution Width to Albumin as a Predictor for Rehospitalization Risk and Rehospitalization All-Cause Mortality in Middle-Aged and Elderly Survivors with Sepsis: An Ambispective ICU Cohort Study

Association between ferritin to albumin ratio and 28-day mortality in patients with sepsis: a retrospective cohort study

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