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. 2023 Jun 20;23(1):417.
doi: 10.1186/s12879-023-08384-9.

The correlation of hemoglobin and 28-day mortality in septic patients: secondary data mining using the MIMIC-IV database

Yu Chen #  1 , Lu Chen #  2 , Zengping Meng  1 , Yi Li  3 , Juan Tang  3 , Shaowen Liu  3 , Li Li  1 , Peisheng Zhang  1 , Qian Chen  3 , Yongmei Liu  4
Affiliations

The correlation of hemoglobin and 28-day mortality in septic patients: secondary data mining using the MIMIC-IV database

Yu Chen et al. BMC Infect Dis. .

Abstract

Background: Previous studies found minimal evidence and raised controversy about the link between hemoglobin and 28-day mortality in sepsis patients. As a result, the purpose of this study was to examine the association between hemoglobin and 28-day death in sepsis patients by analyzing the Medical Intensive Care IV (MIMIC-IV) database from 2008 to 2019 at an advanced medical center in Boston, Massachusetts.

Methods: We extracted 34,916 sepsis patients from the MIMIC-IV retrospective cohort database, using hemoglobin as the exposure variable and 28-day death as the outcome variable, and after adjusting for confounders (demographic indicators, Charlson co-morbidity index, SOFA score, vital signs, medication use status (glucocorticoids, vasoactive drugs, antibiotics, and immunoglobulins, etc.)), we investigated the independent effects of hemoglobin and 28-day risk of death by binary logistic regression as well as two-piecewise linear model, respectively.

Results: Hemoglobin levels and 28-day mortality were shown to be non-linearly related.The inflection points were 104 g/L and 128 g/L, respectively. When HGB levels were between 41 and 104 g/L, there was a 10% decrease in the risk of 28-day mortality (OR: 0.90; 95% CI: 0.87 to 0.94, p-value = 0.0001). However, in the range of 104-128 g/L, we did not observe a significant association between hemoglobin and 28-day mortality (OR: 1.17; 95% CI: 1.00 to 1.35, P value = 0.0586). When HGB was in the range of 128-207 g/L, there was a 7% increase in the risk of 28-day mortality for every 1 unit increase in HGB (OR: 1.07; 95% CI: 1.01 to 1.15, P value = 0.0424).

Conclusion: In patients with sepsis, baseline hemoglobin was related to a U-shaped risk of 28-day death. When HGB was in the range of 12.8-20.7 g/dL, there was a 7% increase in the risk of 28-day mortality for every 1 unit increase in HGB.

Keywords: Hemoglobin; MIMIC-IV; Retrospective study; sepsis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Patient selection process
Fig. 2
Fig. 2
The association between HGB and 28-day mortality
See this image and copyright information in PMC

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