Estimated plasma volume status is a simple and quick tool that could help define the severity of patients with infection on arrival at the emergency department

Turcato, Gianni; Zaboli, Arian; Sibilio, Serena; Brigo, Francesco

doi:10.1016/j.amjms.2024.02.003

Cited by 2 publications

(4 citation statements)

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“…The median ePVS value for patients who died within 30 days was higher than that of survivors (5.83 vs. 4.61, p < 0.001). Multivariate analysis demonstrated that ePVS, both in continuous and categorical forms around the median, was an independent risk factor for 30-day mortality even after adjusting for severity, comorbidity, and urgency ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

“…As a surrogate marker for total vascular volume, it has been validated for its reliability, with multiple studies demonstrating its independent association with outcomes in various heart failure phenotypes (10)(11)(12). Moreover, ePVS has shown prognostic relevance in patients with acute respiratory distress syndrome and fever (13,14). We hypothesize that in patients with septic shock, the total vascular volume will increase following fluid resuscitation due to the systemic vasodilation caused by the inflammatory response, and this increase in total vascular volume is related to the prognosis.…”

Section: Introductionmentioning

confidence: 99%

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Estimated plasma volume status as a simple and accessible predictor of 28-day mortality in septic shock: insights from a retrospective study of the MIMIC-IV database

Gao,

Chen,

Zhao

et al. 2024

Front. Med.

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BackgroundAssessing volume status in septic shock patients is crucial for tailored fluid resuscitation. Estimated plasma volume status (ePVS) has emerged as a simple and effective tool for evaluating patient volume status. However, the prognostic value of ePVS in septic shock patients remains underexplored.MethodsThe study cohort consisted of septic shock patients admitted to the ICU, sourced from the MIMIC-IV database. Patients were categorized into two groups based on 28-day survival outcomes, and their baseline characteristics were compared. According to the ePVS (6.52 dL/g) with a hazard ratio of 1 in the restricted cubic spline (RCS) analysis, patients were further divided into high and low ePVS groups. A multivariable Cox regression model was utilized to evaluate the association between ePVS and 28-day mortality rate. The Kaplan–Meier survival curve was plotted, and all-cause mortality was compared between the high and low groups using the log-rank test.ResultsA total of 7,607 septic shock patients were included in the study, among whom 2,144 (28.2%) died within 28 days. A J-shaped relationship was observed between ePVS at ICU admission and 28-day mortality, with an increase in mortality risk noted when ePVS exceeded 6.52 dL/g. The high ePVS group exhibited notably higher mortality rates compared to the low ePVS group (28-day mortality: 26.2% vs. 30.2%; 90-day mortality: 35% vs. 42.3%). After adjustment for confounding factors, ePVS greater than 6.52 dL/g independently correlated with an increased risk of 28-day mortality (HR: 1.20, 95% CI: 1.10–1.31, p < 0.001) and 90-day mortality (HR: 1.25, 95% CI: 1.15–1.35, p < 0.001). Kaplan–Meier curves demonstrated a heightened risk of mortality associated with ePVS values exceeding 6.52 dL/g.ConclusionA J-shaped association was observed between ePVS and 28-day mortality in septic shock patients, with higher ePVS levels associated with increased risk of mortality.

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Section: Discussionmentioning

confidence: 99%