Hemoglobin levels help predict in-hospital mortality in sepsis patients, finds study

A new study published in the journal of BMC Infectious Diseases showed that hemoglobin levels below or above the threshold of 10.2 g/DL may be associated with worse outcomes in hospitalized sepsis patients. With an estimated 49 million cases per year and a 90-day mortality rate of 35.5%, sepsis continues to be a major cause of death worldwide. The treatment of critically sick patients, especially those with sepsis, depends heavily on hemoglobin, which is essential for oxygen delivery and tissue perfusion.

Increased tissue hypoxia and microcirculation may be made worse by sepsis-induced anemia and changed oxygen demand. Also, hemoglobin is essential for leukocyte support and defense against pathogens. It is still unknown how baseline hemoglobin levels relate to in-hospital mortality in individuals with sepsis. And so, this study was carried out to elucidate this relationship in sepsis patients who were in severe condition.

Sepsis patients were identified retrospectively using the eICU Collaborative Research Database (eICU-CRD) and the Medical Information Mart for Intensive Care-IV (MIMIC-IV 2.2). The relationship between hemoglobin and the probability of in-hospital death was examined using limited cubic spline regression and multivariate logistic regression analysis.

The study comprised a total of 15,495 patients from eICU-CRD and 21,946 patients from MIMIC-IV. In MIMIC-IV, the in-hospital mortality rate was 14.95%, whereas in eICU-CRD, it was 17.40%. After controlling for other factors, multivariate logistic regression revealed a substantial and nonlinear relationship between hemoglobin and the probability of in-hospital death.

Additionally, this study discovered that hemoglobin and in-hospital mortality were nonlinearly correlated, with death plateauing around 10.2 g/dL. Raising hemoglobin levels below 10.2 g/dL reduced the chance of death; raising hemoglobin levels beyond 10.2 g/dL raised the risk. The eICU-CRD dataset confirmed these results.

Hemoglobin levels and in-hospital mortality in critically sick sepsis patients were shown to be severely correlated in a study that included data from two significant intensive care unit databases. Overall, the risk of death rose when hemoglobin levels were above 10.2 g/dL, but it dropped when levels rose above this point. At 10.2 g/dL, mortality risk plateaued, indicating that this is a critical threshold for the best possible patient outcomes.

Source;

Sheng, S., Li, A., Zhang, C., Liu, X., Zhou, W., Shen, T., Ma, Q., Ma, S., & Zhu, F. (2024). Association between hemoglobin and in-hospital mortality in critically ill patients with sepsis: evidence from two large databases. In BMC Infectious Diseases (Vol. 24, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12879-024-10335-x