패혈증 환자에서 혈장내 무세포 혈색소(plasma cell-free hemoglobin)와 사망률의 관계 (Association of plasma cell-free hemoglobin with mortality in patients with sepsis)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 33권 / 5호 / 460 ~ 470페이지
· 저자명 : 변궁도, 황지은, 이재혁, 김중희, 박인원

초록

Objective: This study sought to investigate the association between plasma cell-free hemoglobin (pHb) and mortality in sepsis or septic shock.
Methods: We performed a retrospective analysis of the prospective collected data of patients with sepsis or septic shock.
Patients were divided into 4 groups according to their pHb concentrations using a restricted cubic spline: group I (pHb ≤20 mg/dL), group II (20 < pHb ≤40 mg/dL), group III (40 < pHb ≤60 mg/dL), and group IV (pHb >60 mg/dL). The primary outcome was the 28-day mortality, and a multivariate Cox proportional hazard regression method was used for analysis.
Results: A total of 372 patients were included in the analysis and the overall 28-day mortality rate was 16.7%. The median pHb concentration of the patients was 24.8 mg/dL (reference range, 0-5). The mortality rate did not increase in proportion to the pHb concentrations and was the lowest in group II (20.3%, 11.0%, 16.3%, and 26.7% in groups I, II, III, and IV, respectively). In the Cox proportional hazard regression analysis, group I was independently associated with 28-day mortality compared with group II (hazard ratio, 2.19; 95% confidence interval, 1.18-4.07). Group IV had a higher mortality rate compared to group II, but it was not statistically significant (hazard ratio, 2.17; 95% confidence interval, 0.85-5.56).
Conclusion: A low concentration of pHb (pHb ≤20 mg/dL) was associated with 28-day mortality in patients with sepsis or septic shock.

영어초록

Objective: This study sought to investigate the association between plasma cell-free hemoglobin (pHb) and mortality in sepsis or septic shock.
Methods: We performed a retrospective analysis of the prospective collected data of patients with sepsis or septic shock.
Patients were divided into 4 groups according to their pHb concentrations using a restricted cubic spline: group I (pHb ≤20 mg/dL), group II (20 < pHb ≤40 mg/dL), group III (40 < pHb ≤60 mg/dL), and group IV (pHb >60 mg/dL). The primary outcome was the 28-day mortality, and a multivariate Cox proportional hazard regression method was used for analysis.
Results: A total of 372 patients were included in the analysis and the overall 28-day mortality rate was 16.7%. The median pHb concentration of the patients was 24.8 mg/dL (reference range, 0-5). The mortality rate did not increase in proportion to the pHb concentrations and was the lowest in group II (20.3%, 11.0%, 16.3%, and 26.7% in groups I, II, III, and IV, respectively). In the Cox proportional hazard regression analysis, group I was independently associated with 28-day mortality compared with group II (hazard ratio, 2.19; 95% confidence interval, 1.18-4.07). Group IV had a higher mortality rate compared to group II, but it was not statistically significant (hazard ratio, 2.17; 95% confidence interval, 0.85-5.56).
Conclusion: A low concentration of pHb (pHb ≤20 mg/dL) was associated with 28-day mortality in patients with sepsis or septic shock.

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