脓毒症患者的推荐血细胞比容:一项观察性研究。

Recommended Hematocrit in Patients With Sepsis: An Observational Study.

作者信息

Chen Shih-Hong, Chen Linyi

机构信息

Department of Anesthesiology New Taipei Municipal TuCheng Hospital Taipei Taiwan.

Institute of Molecular Medicine National Tsing Hua University Hsinchu Taiwan.

出版信息

Health Sci Rep. 2025 Jul 9;8(7):e71022. doi: 10.1002/hsr2.71022. eCollection 2025 Jul.

Abstract

BACKGROUND AND AIMS

Sepsis is a critical condition requiring optimized clinical management, especially in terms of hematocrit. The relationship between early stage of hematocrit and mortality in patients with sepsis remains underexplored.

METHOD

This observational cohort study used data from the eICU Collaborative Research Database. Hematocrit within the first 72 h of intensive care unit (ICU) admission in patients with sepsis was analyzed. The association of hematocrit with hospital and ICU mortality was assessed using generalized additive models, and inverse probability of treatment weighting was applied to ensure the balanced distributions of variables between the groups.

RESULTS

Our analysis revealed a pivotal hematocrit threshold of 33%. Below this value, the risks of all-cause hospital and ICU mortality significantly decreased. This nonlinear association underscores the importance of maintaining hematocrit above this value. Thus, hematocrit can serve as a critical marker for predicting clinical outcomes and improving patient management in the early phase of sepsis treatment.

CONCLUSION

Early management of hematocrit is critical in patients with sepsis; maintaining hematocrit above 33% can improve survival outcomes among these patients. These findings suggest that anemia treatment strategies in sepsis care should be re-evaluated, and they demonstrate the importance of personalized management of hematocrit for enhancing patient prognosis.

摘要

背景与目的

脓毒症是一种危急病症,需要优化临床管理,尤其是在血细胞比容方面。脓毒症患者早期血细胞比容与死亡率之间的关系仍未得到充分研究。

方法

这项观察性队列研究使用了eICU协作研究数据库中的数据。分析了脓毒症患者入住重症监护病房(ICU)后最初72小时内的血细胞比容。使用广义相加模型评估血细胞比容与医院死亡率和ICU死亡率的关联,并应用治疗权重逆概率来确保各组之间变量的均衡分布。

结果

我们的分析揭示了一个关键的血细胞比容阈值为33%。低于该值,全因医院死亡率和ICU死亡率的风险显著降低。这种非线性关联强调了将血细胞比容维持在该值以上的重要性。因此,血细胞比容可作为预测脓毒症治疗早期临床结局和改善患者管理的关键指标。

结论

脓毒症患者早期血细胞比容管理至关重要;将血细胞比容维持在33%以上可改善这些患者的生存结局。这些发现表明,应重新评估脓毒症护理中的贫血治疗策略,并且它们证明了个性化管理血细胞比容对改善患者预后的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e392/12241426/930cb648f4b0/HSR2-8-e71022-g002.jpg

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