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. 2023 May 27;23(1):187.
doi: 10.1186/s12890-023-02491-8.

The PaO2/FiO2 is independently associated with 28-day mortality in patients with sepsis: a retrospective analysis from MIMIC-IV database

Hongying Bi  1 , Xu Liu  2 , Chi Chen  3 , Lu Chen  4 , Xian Liu  1 , Jianmin Zhong  5 , Yan Tang  1
Affiliations

The PaO2/FiO2 is independently associated with 28-day mortality in patients with sepsis: a retrospective analysis from MIMIC-IV database

Hongying Bi et al. BMC Pulm Med. .

Abstract

Background: To clarify the relationship between the PaO2/FiO2 and 28-day mortality in patients with sepsis.

Methods: This was a retrospective cohort study regarding MIMIC-IV database. Nineteen thousand two hundred thirty-three patients with sepsis were included in the final analysis. PaO2/FiO2 was exposure variable, 28-day mortality was outcome variable. PaO2/FiO2 was log-transformed as LnPaO2/FiO2. Binary logistic regression was used to explore the independent effects of LnPaO2/FiO2 on 28-day mortality using non-adjusted and multivariate-adjusted models. A generalized additive model (GAM) and smoothed curve fitting was used to investigate the non-linear relationship between LnPaO2/FiO2 and 28-day mortality. A two-piecewise linear model was used to calculate the OR and 95% CI on either side of the inflection point.

Results: The relationship between LnPaO2/FiO2 and risk of 28-day death in sepsis patients was U-shape. The inflection point of LnPaO2/FiO2 was 5.30 (95%CI: 5.21-5.39), which indicated the inflection point of PaO2/FiO2 was 200.33 mmHg (95%CI: 183.09 mmHg-219.20 mmHg). On the left of inflection point, LnPaO2/FiO2 was negatively correlated with 28-day mortality (OR: 0.37, 95%CI: 0.32-0.43, p < 0.0001). On the right of inflection point, LnPaO2/FiO2 was positively correlated with 28-day mortality in patients with sepsis (OR: 1.53, 95%CI: 1.31-1.80, p < 0.0001).

Conclusions: In patients with sepsis, either a high or low PaO2/FiO2 was associated with an increased risk of 28-day mortality. In the range of 183.09 mmHg to 219.20 mmHg, PaO2/FiO2 was associated with a lower risk of 28-day death in patients with sepsis.

Keywords: 28-day mortality; MIMIC-IV database; PaO2/FiO2; Sepsis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart. MIMIC: Medical Information Mart for Intensive Care
Fig. 2
Fig. 2
The non-linear relationship between PaO2/FiO2 and 28-day mortality in patients with sepsis
See this image and copyright information in PMC

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