{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T07:18:41Z","timestamp":1787815121426,"version":"build-2784847793"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Kaohsiung J of Med Scie"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    This retrospective cohort study evaluated the association between estimated plasma volume status (ePVS) and in\u2010hospital mortality in adult patients with sepsis from the MIMIC\u2010IV (v2.2) database. After excluding patients with early death, readmission, red blood cell transfusion, malignancy, or missing ePVS data, 17,403 patients meeting Sepsis\u20103 criteria were included. ePVS was calculated using hemoglobin and hematocrit. Early ePVS (ePVS1), late\u2010ICU ePVS (ePVS2), and ePVS change were analyzed using multivariable logistic regression, restricted cubic splines, threshold analysis, prediction metrics, Kaplan\u2013Meier analysis, subgroup analysis, and sensitivity analyses. In\u2010hospital mortality was 13.2%. ePVS2 and ePVS change were significantly higher in non\u2010survivors, whereas the difference in ePVS1 was small. After adjustment, ePVS2 (adjusted odds ratio [OR]\u2009=\u20091.14, 95% confidence interval [CI]: 1.11\u20131.18,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and ePVS change (adjusted OR\u2009=\u20091.04, 95% CI: 1.02\u20131.05,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) remained independently associated with in\u2010hospital mortality, while ePVS1 was not significant. Non\u2010linear and threshold analyses suggested lower risk at ePVS2 of approximately 6\u20138\u2009dL\/g and ePVS change of \u22124.5 to 2, with increased risk at ePVS2\u2009\u2265\u20098\u2009dL\/g or ePVS change \u2265\u20092. Late\u2010ICU ePVS2 and ePVS change may supplement volume\u2010status assessment and short\u2010term prognostic stratification in sepsis, but prospective validation is needed.\n                  <\/jats:p>","DOI":"10.1002\/kjm2.70278","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:41:52Z","timestamp":1787812912000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Non\u2010Linear Threshold Effect of Dynamic Estimated Plasma Volume Status on Revealing In\u2010Hospital Mortality Risk in Sepsis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9221-4821","authenticated-orcid":false,"given":"Zhi\u2010An","family":"Si","sequence":"first","affiliation":[{"name":"Department of Oncology The 989th Hospital of the Joint Logistics Support Force of the PLA  Luoyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng\u2010Bing","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine The 989th Hospital of the Joint Logistics Support Force of the PLA  Luoyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Cardiology The 989th Hospital of the Joint Logistics Support Force of the PLA  Luoyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4291-7776","authenticated-orcid":false,"given":"Xiao\u2010Yan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition The First Affiliated Hospital of Chengdu Medical College  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/epidemiologia5030032"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32989-7"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005337"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12093188"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.7560"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.5114\/ait.2022.115368"},{"issue":"1","key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1186\/s13054-024-05078-9","article-title":"Assessment of Fluid Responsiveness Using Pulse Pressure Variation, Stroke Volume Variation, Plethysmographic Variability Index, Central Venous Pressure, and Inferior Vena Cava Variation in Patients Undergoing Mechanical Ventilation: A Systematic Review and Meta\u2010Analysis","volume":"28","author":"Chaves R. C. F.","year":"2024","journal-title":"Critical Care"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-022-06808-9"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004617"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-018-0402-x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000534"},{"issue":"18","key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"e145","DOI":"10.3346\/jkms.2022.37.e145","article-title":"Prognostic Value of Estimated Plasma Volume Status in Patients With Sepsis","volume":"37","author":"Kim K. H.","year":"2022","journal-title":"Journal of Korean Medical Science"},{"key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"1416396","DOI":"10.3389\/fmed.2024.1416396","article-title":"Estimated Plasma Volume Status as a Simple and Accessible Predictor of 28\u2010Day Mortality in Septic Shock: Insights From a Retrospective Study of the MIMIC\u2010IV Database","volume":"11","author":"Gao B.","year":"2024","journal-title":"Frontiers in Medicine"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41597-022-01899-x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2015.06.014"},{"issue":"8","key":"e_1_2_8_18_1","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1172\/JCI102501","article-title":"Water Diuresis Produced During Recumbency by the Intravenous Infusion of Isotonic Saline Solution","volume":"30","author":"Strauss M. 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