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铁代谢指标和维生素D水平对脓毒症和脓毒性休克患者临床结局的影响:一项三级医疗中心的横断面分析

Impact of Iron Profile and Vitamin D Levels on Clinical Outcomes in Patients with Sepsis and Septic Shock: A Cross-sectional Analysis at a Tertiary Care Center.

作者信息

Bairwa Mukesh, Jatteppanavar Basavaraj, Kant Ravi, Singh Mahendra, Choudhury Arnab

机构信息

Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

Department of General Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

出版信息

Indian J Crit Care Med. 2024 Jun;28(6):569-574. doi: 10.5005/jp-journals-10071-24726.

Abstract

AIM AND BACKGROUND

Sepsis is a major global health affecting millions worldwide, hence understanding its contributing factors becomes paramount. This cross-sectional study at a tertiary care center explores the relationship between iron profile, vitamin D levels, and outcomes in sepsis and septic shock patients. The primary objective was to explore the prevalence of iron profile and vitamin D parameters during early intensive care unit (ICU) admission and their association with 28-day mortality.

MATERIALS AND METHODS

Spanning 18 months, the study enrolled adult patients meeting sepsis or septic shock criteria at the ICU. Data collection included demographic information, clinical characteristics, and blood samples for iron profile and vitamin D levels at admission. Disease severity was assessed using sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE II) scores, and treatment was administered as per surviving sepsis-3 guidelines.

RESULTS

The research involved 142 participants, uncovering prevalent organisms such as , , and . Noteworthy connections to mortality were identified for factors including vasopressor support, ICU stay duration, SOFA score, and APACHE-II score. Interestingly, age, gender, and vitamin D levels showed no significant associations. However, the study did reveal a significant association between iron, ferritin, and transferrin saturation levels with increased 28-day mortality.

CONCLUSION

Our study concluded that low Iron, elevated ferritin, and decreased transferrin saturation levels maintained associations with the outcome of interest. While no such relationship was established with vitamin D levels. These results suggest potential implications for patient management and prognosis, warranting further exploration in future research.

HOW TO CITE THIS ARTICLE

Bairwa M, Jatteppanavar B, Kant R, Singh M, Choudhury A. Impact of Iron Profile and Vitamin D Levels on Clinical Outcomes in Patients with Sepsis and Septic Shock: A Cross-sectional Analysis at a Tertiary Care Center. Indian J Crit Care Med 2024;28(6):569-574.

摘要

目的与背景

脓毒症是一个影响全球数百万人的主要公共卫生问题,因此了解其促成因素至关重要。这项在三级护理中心进行的横断面研究探讨了脓毒症和脓毒性休克患者的铁代谢指标、维生素D水平与预后之间的关系。主要目的是探讨在重症监护病房(ICU)早期入院时铁代谢指标和维生素D参数的患病率及其与28天死亡率的关联。

材料与方法

该研究历时18个月,纳入了在ICU符合脓毒症或脓毒性休克标准的成年患者。数据收集包括人口统计学信息、临床特征以及入院时用于检测铁代谢指标和维生素D水平的血样。使用序贯器官衰竭评估(SOFA)和急性生理与慢性健康状况评分系统II(APACHE II)对疾病严重程度进行评估,并按照脓毒症存活指南3进行治疗。

结果

该研究涉及142名参与者,发现了诸如[此处原文缺失具体微生物名称]等常见病原体。确定了与死亡率有显著关联的因素,包括血管升压药支持、ICU住院时间、SOFA评分和APACHE-II评分。有趣的是,年龄、性别和维生素D水平未显示出显著关联。然而,该研究确实揭示了铁、铁蛋白和转铁蛋白饱和度水平与28天死亡率增加之间存在显著关联。

结论

我们的研究得出结论,低铁、铁蛋白升高和转铁蛋白饱和度降低与感兴趣的结局保持关联。而与维生素D水平未建立此类关系。这些结果表明对患者管理和预后可能具有潜在影响,值得在未来研究中进一步探索。

如何引用本文

Bairwa M, Jatteppanavar B, Kant R, Singh M, Choudhury A. 铁代谢指标和维生素D水平对脓毒症和脓毒性休克患者临床结局的影响:三级护理中心的横断面分析。《印度重症监护医学杂志》2024;28(6):569 - 574。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed97/11310672/bce08dfd845c/ijccm-28-569-g001.jpg

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