The following is a summary of “Clinical significance of hemoglobin level and blood transfusion therapy in elderly sepsis patients: A retrospective analysis,” published in the November 2023 issue of Emergency Medicine by Yang, et al.

The clinical implications of hemoglobin levels and blood transfusion therapy in elderly sepsis patients remain debated. For a study, researchers sought to explore the relationship between mortality, hemoglobin levels, and blood transfusion in the population.

Elderly sepsis patients from the Marketplace for Medical Information in Intensive Care (MIMIC-IV) database were analyzed. A multivariate regression model assessed the association between hemoglobin (Hb) levels and 28-day mortality risk. Logistic Multivariate analysis, Propensity Matching (PSM), Inverse Probabilities Weighting (IPW), and doubly robust estimation analyzed mortality risk between transfused and non-transfused patients across different Hb groups.

The study included 7,473 elderly sepsis patients, revealing a non-linear relationship between ICU Hb levels and 28-day mortality risk. Patients with Hb levels <10 g/dL (P < 0.05) and >15 g/dL (P < 0.05) within 24 hours showed increased mortality risk in multivariate analysis. For Hb levels 7–8 g/dL and 8–9 g/dL subgroups, various analyses (Multivariate, PSM, IPW, doubly robust estimation) indicated that blood transfusion reduced mortality risk (P < 0.05). Conversely, in the 10–11 g/dL subgroup, IPW (P < 0.05) and doubly robust estimation (P< 0.05) suggested that blood transfusion increased mortality risk.

A non-linear relationship exists between Hb levels and 28-day mortality risk, with Hb levels <10 g/dL and >15 g/dL increasing mortality risk. Blood transfusion at Hb levels <9 g/dL may mitigate mortality risk in elderly sepsis patients.

Source: sciencedirect.com/science/article/abs/pii/S0735675723004230