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Background: Accumulation of iron is associated with oxidative stress, inflammation, and regulated cell death processes that contribute to the development of acute kidney injury (AKI). We aimed to investigate the association between serum iron levels and prognosis in intensive care unit (ICU) patients with AKI., Methods: A total of 483 patients with AKI defined as per the Kidney Disease: Improving Global Guidelines were included in this retrospective study. The data was extracted from the single-centre Medical Information Mart for Intensive Care III database. AKI patients with serum iron parameters measured upon ICU admission were included and divided into two groups (low group and high group). The prognostic value of serum iron was analysed using univariate and multivariate Cox regression analysis., Results: The optimal cut-off value for serum iron was calculated to be 60 μg/dl. Univariable Cox regression analysis showed that serum iron levels were significantly correlated with prognosis of AKI patients. After adjusting for possible confounding variables, serum iron levels higher than 60 μg/dl were associated with increases in 28-day (hazard [HR] 1.832; P <  0.001) and 90-day (HR 1.741; P <  0.001) mortality, as per multivariable Cox regression analysis., Conclusions: High serum iron levels were associated with increased short- and long-term mortality in ICU patients with AKI. Serum iron levels measured upon admission may be used for predicting prognosis in AKI patients.

Background and Objectives: Thrombocytopenia is common among sepsis patients. Platelet transfusions are frequently administered to increase platelet counts, but their clinical impacts remain unclear in sepsis‐induced thrombocytopenia. The goal of this study was to explore the association between platelet transfusion and mortality in patients with sepsis‐induced thrombocytopenia. Materials and Methods: The study was based on the Medical Information Mart for Intensive Care (MIMIC) III database. Septic patients with severe thrombocytopenia (a platelet count ≤ 50/nl) were included in the study and were divided into two groups: a platelet transfusion group (PT group) and a no platelet transfusion group (NPT group). The primary outcome was in‐hospital mortality, and the secondary outcomes were the length of intensive care unit (ICU) stay (LOS‐ICU) and 90‐day mortality. Propensity score matching multivariable logistic regression was used to reduce the imbalance. Results: A total of 1733 patients were included: 296 patients were included in the PT group and 1437 patients were included in the NPT group. After propensity score matching, 296 paired patients constituted each group. Crude hospital mortality was significantly higher in the PT group than in the NPT group (145 [48.99%] vs. 567 [39.46%], p = 0.002). In the extended multivariable logistic models for hospital mortality, the odds ratio (OR) of receiving a platelet transfusion was consistently significant in all six models (OR range, 1.340–1.525, p < 0.05 for all). In the following subgroups, platelet transfusion was associated with increased in‐hospital mortality: age > 60 years; sex: female; sequential organ failure assessment score ≤8; simplified acute physiology score ≤ 47; platelet count >29/nl and the complication of congestive heart failure. However, there were no significant differences in the 90‐day mortality rate (170 [57.43%] vs. 741 [51.57%], p = 0.066) or the LOS‐ICU (5.84 [2.68–11.78] vs. 4.94 [2.18–12.72], p = 0.442) between the two groups. All these results remained stable after adjustment for confounders and in the comparisons after propensity score matching. Conclusions: The propensity score‐matched analysis showed that platelet transfusion was associated with increased in‐hospital mortality in septic patients with severe thrombocytopenia (a platelet count ≤ 50/nl). However, it was not associated with 90‐day mortality or the length of ICU stay. [ABSTRACT FROM AUTHOR]

Background. Alcohol use disorder (AUD) is common in critically ill patients. Plasma anion gap (AG) was known as a feasible parameter and was associated with outcomes of various diseases. This study is intended to explore whether AG is related to 28-day inhospital mortality and 1-year mortality of critically ill patients with AUD. Method. We extracted data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The association of plasma AG with 28-day inhospital mortality and 1-year mortality of critically ill AUD patients was assessed using Cox proportional hazard regression models and stratification analyses, allowing AG as a time-varying covariate in the models. To evaluate the accuracy of AG in predicting different endpoints, receiver operator characteristic (ROC) curves were used. Result. Among the 3993 critically ill patients with AUD, AG was positively associated with 28-day inhospital mortality and 1-year mortality after adjusting confounders (p < 0.001 for all). Compared with lower AG (<12 mmol/L), patients in different groups (12 ≤ AG < 14 mmol/L, 14 ≤ AG < 17 mmol/L, 17 ≤ AG < 20 mmol/L, and AG ≥ 20 mmol/L) had different HRs (95% CIs) for 28-day inhospital mortality (1.105, (0.906, 1.347); 1.171, (0.981, 1.398); 1.320, (1.108, 1.573); and 1.487, (1.254, 1.763), respectively) and 1-year mortality (1.037 (0.898, 1.196); 1.091 (0.955, 1.246); 1.201 (1.052, 1.371); and 1.3093 (1.149, 1.492), respectively). Conclusion. Increased AG is associated with greater 28-day inhospital mortality and 1-year mortality. The effect of AG on all-cause mortality is linear in critically ill AUD patients. [ABSTRACT FROM AUTHOR]

Background. Elevated red cell distribution width (RDW) has been reported to be associated with mortality in some critically ill patient populations. The aim of this article is to investigate the relationship between RDW and in-hospital mortality and short- and long-term mortality of patients with cholecystitis. Method. We conducted a retrospective cohort study in which data from all 702 patients extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database were used. Receiver operating characteristic (ROC) curves were constructed to evaluate the prognostic predictive value of RDW for in-hospital mortality and short- (i.e., 30-day and 90-day) and long-term (i.e., 180-day, 1-year, 3-year, and 5-year) mortality. We converted RDW into a categorical variable according to quintiles as less than or equal to 13.9%, 14.0-14.8%, 14.9-15.8%, and 15.9-17.2% and more than 17.2%. The Kaplan-Meier (K-M) methods and log-rank tests were used to compare survival differences among different groups. The relationships between RDW levels and in-hospital mortality were evaluated by univariate and multivariate binary logistic regression models. Multivariable Cox regression models were built to investigate the association of RDW on the short-term and long-term mortality. Result. After adjusting for potential confounders, RDW was positively associated with in-hospital mortality (OR: 1.187, 95% CI [1.049, 1.343]) and short- (i.e., 30-day: HR: 1.183, 95% CI [1.080, 1.295], 90-day: HR: 1.175, 95% CI [1.089, 1.268]) and long-term (i.e., 1-year: HR:1.162, 95% CI [1.089, 1.240]) mortality in critically ill patients with cholecystitis. Similar results were also shown in the secondary outcomes of 180-day, 3-year, and 5-year mortality. RDW had a significant accurate prognostic effect on different endpoints and could improve the prognostic effect of scoring systems. Conclusion. High level of RDW is associated with an increased risk of in-hospital mortality and short- and long-term mortality in critically ill patients with cholecystitis. RDW can independently predict the prognosis of patients with cholecystitis. [ABSTRACT FROM AUTHOR]