Association of number of days with severe anemia in the first week with 28-Day mortality in patients with sepsis: propensity score-based analyses

Abstract

<title>Abstract</title> Anemia is a common occurrence during sepsis. However, the relationship between anemia duration and short-term effects on mortality in patients with sepsis remains unclear. This study examined the association between number of days with severe anemia in the first week and 28-day mortality rate among patients with sepsis. This retrospective cohort study used the clinical data extracted from Medical Information Mart for Intensive Care IV 2.2. A total of 1335 patients with sepsis were included in the study. After adjusting for confounders, the 28-day mortality of patients with sepsis increased with each additional day of severe anemia (hemoglobin level &lt; 8 g/dl) in the first week of intensive care unit admission with an odds ratio (OR) of 1.12 (95% confidence interval (CI) [1.05; 1.2], P &lt; 0.001). Furthermore, patients who experienced severe anemia for at least three days had a higher 28-day mortality rate than those with less severe anemia below three days (OR: 1.59, 95% CI [1.19; 2.11], P = 0.002). After employing various propensity score matching methods, we consistently observed a similar association. The adjusted ORs in propensity score matching, inverse probability of treatment weighting, standardized mortality ratio weighting, pairwise algorithmic, and overlap weight were 1.49 (95% CI, 1.08 ~ 2.07, P = 0.016), 1.65 (95% CI, 1.28 ~ 2.12, P &lt; 0.001), 1.49 (95% CI, 1.16 ~ 1.93, P = 0.002), 1.48 (95% CI, 1.07 ~ 2.04, P = 0.018), and 1.48 (95% CI, 1.01 ~ 2.17, P = 0.044) respectively. Thus, this study suggests that a longer duration of severe anemia in the first week may be linked to increased 28-day mortality in patients with sepsis.