{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:39:54Z","timestamp":1788968394488,"version":"build-2803163510"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T00:00:00Z","timestamp":1717632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Assessing 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The 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\u2009dL\/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\u2013Meier survival curve was plotted, and all-cause mortality was compared between the high and low groups using the log-rank test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 7,607 septic shock patients were included in the study, among whom 2,144 (28.2%) died within 28\u2009days. 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\u2009dL\/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\u2009dL\/g independently correlated with an increased risk of 28-day mortality (HR: 1.20, 95% CI: 1.10\u20131.31, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) and 90-day mortality (HR: 1.25, 95% CI: 1.15\u20131.35, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). Kaplan\u2013Meier curves demonstrated a heightened risk of mortality associated with ePVS values exceeding 6.52\u2009dL\/g.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A 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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1416396","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T19:21:42Z","timestamp":1718133702000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["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"],"prefix":"10.3389","volume":"11","author":[{"given":"Beijun","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongping","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoting","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1007\/s00134-021-06595-9","article-title":"Current practice and evolving concepts in septic shock resuscitation","volume":"48","author":"Bakker","year":"2022","journal-title":"Intensive Care Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1007\/s00134-021-06506-y","article-title":"Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021","volume":"47","author":"Evans","year":"2021","journal-title":"Intensive Care Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1097\/01.CCM.0000194725.48928.3A","article-title":"Sepsis in European intensive care units: results of the SOAP study*","volume":"34","author":"Vincent","year":"2006","journal-title":"Crit Care Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1007\/s00392-020-01606-z","article-title":"Estimated plasma volume and mortality: analysis from NHANES 1999\u20132014","volume":"109","author":"Marawan","year":"2020","journal-title":"Clin Res Cardiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1038\/nature01326","article-title":"The immunopathogenesis of sepsis","volume":"420","author":"Cohen","year":"2002","journal-title":"Nature"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13054-016-1438-7","article-title":"Volume and its relationship to cardiac output and venous return","volume":"20","author":"Magder","year":"2016","journal-title":"Crit Care"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1186\/s13054-022-04255-y","article-title":"A plea for personalization of the hemodynamic management of septic shock","volume":"26","author":"De Backer","year":"2022","journal-title":"Crit Care"},{"key":"ref8","doi-asserted-by":"publisher","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","year":"1951","journal-title":"J Clin Invest"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1016\/j.jchf.2015.06.014","article-title":"Prognostic value of estimated plasma volume in heart failure. 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