Influence of fluid balance on the prognosis of patients with sepsis

Abstract Background Early and timely fluid treatment or resuscitation are the basic measures for the active treatment of sepsis. Our aim is to further explore the relationship between fluid balance and prognosis in patients with sepsis on a daily basis for 5 days. Methods Sepsis patients in eICU Col...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Luming Zhang, Fengshuo Xu, Shaojin Li, Xiaoyu Zheng, Shuai Zheng, Hui Liu, Jun Lyu, Haiyan Yin
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	sepsis eICU-CRD Fluid balance Prognosis Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/6d95e9f158cb42ee8dd14e55ac26ce56
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:6d95e9f158cb42ee8dd14e55ac26ce56
record_format	dspace
spelling	oai:doaj.org-article:6d95e9f158cb42ee8dd14e55ac26ce562021-11-07T12:18:24ZInfluence of fluid balance on the prognosis of patients with sepsis10.1186/s12871-021-01489-11471-2253https://doaj.org/article/6d95e9f158cb42ee8dd14e55ac26ce562021-11-01T00:00:00Zhttps://doi.org/10.1186/s12871-021-01489-1https://doaj.org/toc/1471-2253Abstract Background Early and timely fluid treatment or resuscitation are the basic measures for the active treatment of sepsis. Our aim is to further explore the relationship between fluid balance and prognosis in patients with sepsis on a daily basis for 5 days. Methods Sepsis patients in eICU Collaborative Research Database were divided into the negative balance group (NB/−) and the positive balance group (PB/+) according to daily fluid balance. The primary outcome was in-hospital mortality. Survival differences between the groups were analyzed by using Cox regression. Then dose-response relationship between fluid balance and in-hospital mortality was studied using restricted cubic splines (RCSs). Furthermore, patients with fluid balance data for the previous three consecutive days were selected and divided into eight groups (“+/+/+”, “+/+/−”, “+/ −/−”, “+/ −/+”, “−/ −/−”, “−/ −/+”, “−/+/+”, and “−/+/−”). Kaplan–Meier curves and Cox regression were used to show the survival difference between groups. Results Our study, which included 19,557 patients in a multicenter database, showed that positive fluid balances on days 1, 2, and 3 after sepsis diagnosis were associated with poor prognosis with the HRs of 1.29 (1.20,1.40), 1.13 (1.01,1.27), and 1.25 (1.08,1.44), respectively, while the fluid balance on days 4 and 5 had no effect on the primary outcome. Then RCSs showed an overall trend that the risk of in-hospital mortality on days 1, 2, and 3 increased with increasing fluid balance. For three consecutive days of fluid balance, we studied 9205 patients and Kaplan–Meier curves revealed survival differences among patients in the eight groups. The cox model demonstrated that compared with the “+/+/+” group, the “+/ −/−”, “−/ −/−”, “−/ −/+”, “−/+/+”, and “−/+/−” groups had a lower risk of in-hospital mortality, with HRs of 0.65 (0.45,0.93), 0.72 (0.60,0.86), 0.63 (0.43,0.93), 0.69 (0.48,0.98), and 0.63 (0.42,0.96), respectively. Conclusions In patients with sepsis, positive fluid balance on days 1, 2, and 3 was associated with adverse outcomes. For patients with fluid balance for three consecutive days, the “+/−/−”, “−/ −/−”, “−/−/+”, “−/+/+”, and “−/+/−” groups were less likely to die in hospital than the “+/+/+” group.Luming ZhangFengshuo XuShaojin LiXiaoyu ZhengShuai ZhengHui LiuJun LyuHaiyan YinBMCarticlesepsiseICU-CRDFluid balancePrognosisAnesthesiologyRD78.3-87.3ENBMC Anesthesiology, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	sepsis eICU-CRD Fluid balance Prognosis Anesthesiology RD78.3-87.3
spellingShingle	sepsis eICU-CRD Fluid balance Prognosis Anesthesiology RD78.3-87.3 Luming Zhang Fengshuo Xu Shaojin Li Xiaoyu Zheng Shuai Zheng Hui Liu Jun Lyu Haiyan Yin Influence of fluid balance on the prognosis of patients with sepsis
description	Abstract Background Early and timely fluid treatment or resuscitation are the basic measures for the active treatment of sepsis. Our aim is to further explore the relationship between fluid balance and prognosis in patients with sepsis on a daily basis for 5 days. Methods Sepsis patients in eICU Collaborative Research Database were divided into the negative balance group (NB/−) and the positive balance group (PB/+) according to daily fluid balance. The primary outcome was in-hospital mortality. Survival differences between the groups were analyzed by using Cox regression. Then dose-response relationship between fluid balance and in-hospital mortality was studied using restricted cubic splines (RCSs). Furthermore, patients with fluid balance data for the previous three consecutive days were selected and divided into eight groups (“+/+/+”, “+/+/−”, “+/ −/−”, “+/ −/+”, “−/ −/−”, “−/ −/+”, “−/+/+”, and “−/+/−”). Kaplan–Meier curves and Cox regression were used to show the survival difference between groups. Results Our study, which included 19,557 patients in a multicenter database, showed that positive fluid balances on days 1, 2, and 3 after sepsis diagnosis were associated with poor prognosis with the HRs of 1.29 (1.20,1.40), 1.13 (1.01,1.27), and 1.25 (1.08,1.44), respectively, while the fluid balance on days 4 and 5 had no effect on the primary outcome. Then RCSs showed an overall trend that the risk of in-hospital mortality on days 1, 2, and 3 increased with increasing fluid balance. For three consecutive days of fluid balance, we studied 9205 patients and Kaplan–Meier curves revealed survival differences among patients in the eight groups. The cox model demonstrated that compared with the “+/+/+” group, the “+/ −/−”, “−/ −/−”, “−/ −/+”, “−/+/+”, and “−/+/−” groups had a lower risk of in-hospital mortality, with HRs of 0.65 (0.45,0.93), 0.72 (0.60,0.86), 0.63 (0.43,0.93), 0.69 (0.48,0.98), and 0.63 (0.42,0.96), respectively. Conclusions In patients with sepsis, positive fluid balance on days 1, 2, and 3 was associated with adverse outcomes. For patients with fluid balance for three consecutive days, the “+/−/−”, “−/ −/−”, “−/−/+”, “−/+/+”, and “−/+/−” groups were less likely to die in hospital than the “+/+/+” group.
format	article
author	Luming Zhang Fengshuo Xu Shaojin Li Xiaoyu Zheng Shuai Zheng Hui Liu Jun Lyu Haiyan Yin
author_facet	Luming Zhang Fengshuo Xu Shaojin Li Xiaoyu Zheng Shuai Zheng Hui Liu Jun Lyu Haiyan Yin
author_sort	Luming Zhang
title	Influence of fluid balance on the prognosis of patients with sepsis
title_short	Influence of fluid balance on the prognosis of patients with sepsis
title_full	Influence of fluid balance on the prognosis of patients with sepsis
title_fullStr	Influence of fluid balance on the prognosis of patients with sepsis
title_full_unstemmed	Influence of fluid balance on the prognosis of patients with sepsis
title_sort	influence of fluid balance on the prognosis of patients with sepsis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/6d95e9f158cb42ee8dd14e55ac26ce56
work_keys_str_mv	AT lumingzhang influenceoffluidbalanceontheprognosisofpatientswithsepsis AT fengshuoxu influenceoffluidbalanceontheprognosisofpatientswithsepsis AT shaojinli influenceoffluidbalanceontheprognosisofpatientswithsepsis AT xiaoyuzheng influenceoffluidbalanceontheprognosisofpatientswithsepsis AT shuaizheng influenceoffluidbalanceontheprognosisofpatientswithsepsis AT huiliu influenceoffluidbalanceontheprognosisofpatientswithsepsis AT junlyu influenceoffluidbalanceontheprognosisofpatientswithsepsis AT haiyanyin influenceoffluidbalanceontheprognosisofpatientswithsepsis
_version_	1718443493464997888

Influence of fluid balance on the prognosis of patients with sepsis

Ejemplares similares