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J Korean Soc Emerg Med > Volume 33(5); 2022 > Article
Journal of The Korean Society of Emergency Medicine 2022;33(5): 460-470.
패혈증 환자에서 혈장내 무세포 혈색소(plasma cell-free hemoglobin)와 사망률의 관계
변궁도 , 황지은 , 이재혁 , 김중희 , 박인원
분당서울대학교병원 응급의학과
Association of plasma cell-free hemoglobin with mortality in patients with sepsis
Gungdo Byun , Ji Eun Hwang , Jae Hyuk Lee , Joonghee Kim , Inwon Park
Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
Correspondence  Ji Eun Hwang ,Tel: 031-787-7584, Fax: 031-787-4081, Email: trigonotis6@gmail.com,
Received: September 30, 2021; Revised: October 17, 2021   Accepted: October 19, 2021.  Published online: October 31, 2022.
This study sought to investigate the association between plasma cell-free hemoglobin (pHb) and mortality in sepsis or septic shock.
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.
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).
A low concentration of pHb (pHb ≤20 mg/dL) was associated with 28-day mortality in patients with sepsis or septic shock.
Key words: Sepsis; Cell-free hemoglobin; Mortality
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