Association between albumin-corrected calcium and prognosis in patients with sepsis: a retrospective study based on the MIMIC-IV database

Abstract

Sepsis is a serious systemic inflammatory response syndrome characterized by a high death rate and a perilous disease course. Therefore, prognostic assessment in the treatment of sepsis is crucial.

This study aims to elucidate the relationship between albumin-corrected calcium (ACC) levels and the prognosis of sepsis patients. Data were obtained from the MIMIC-IV 2.2 database for patients with sepsis admitted to the intensive care unit (ICU). The primary outcome was the risk of all-cause mortality (ACM) within 30 days of ICU admission. The secondary outcome was the ICU length of stay (LOS). 6243 patients were included. Patients were divided into the low ACC group (ACC < 8.86) and the high ACC group (ACC ≥ 8.86). The restricted cubic spline curve indicated a linear association between ACC levels and 30-day risk of ACM (P for nonlinear = 0.343). Multivariate Cox regression showed that ACC was positively correlated with 30-day risk of ACM (hazard ratio (HR = 1.19, 95% confidence interval (CI): 1.12, 1.27). Results after PSM were consistent with those prior to matching. The KM survival curve indicated a significant survival difference across the low and high ACC groups (p < 0.0001). Subgroup analyses demonstrated that the correlation between ACC levels and 30-day risk of ACM remained stable. The findings suggest that ACC levels are independently associated with the prognosis of sepsis patients. ACC may act as a novel biomarker for the prognosis of sepsis.