Association between vitamin E and 28-day mortality in adult sepsis patients: A retrospective cohort analysis.

BACKGROUND

Currently, there is no definitive conclusion on the impact of standalone use of vitamin E in adult sepsis patients in the ICU on the 28-day mortality rate. This study hypothesizes that vitamin E can improve the prognosis of adult sepsis patients.

METHODS

We analyzed adult sepsis patients (According to the international diagnostic criteria of sepsis 3.0) from the Medical Information Mart for Intensive Care IV Database (MIMIC-IV). A multivariate regression, propensity score analysis, and interaction effects were used to determine the associations between vitamin E intake and 28-day mortality rates in ICU.

RESULTS

There was no significant reduction in 28-day mortality among patients who used vitamin E (treatment group) compared to those who did not use it (control group) in the preliminary observation and univariate analysis (hazard ratio = 0.89, 95 % confidence interval = 0.7-1.14, p = 0.361). After adjusting for all the covariates in multivariate Cox regression analysis, the hazard ratio is 0.75(95 % CI: 0.59∼0.95, p = 0.019). We also established two additional models for the relationship between vitamin E and mortality by adjusting different covariates. The adjusted HR values in model 1 and model 2 were 0.77 (95 % CI: 0.61-0.98, p = 0.035) and 0.75 (95 % CI: 0.59-0.96, p = 0.021), respectively. In the propensity score matching (PSM) model, we observed that the Multivariable-Adjusted, Propensity Score-adjusted, Weighted SMRW, Weighted PA, and Weighted Ow all have HR values <1, with p-values <0.05, and consistent trends in all results.

CONCLUSIONS

In a general population of critically ill patients with adult sepsis, the use of vitamin E is associated with reduced 28-day mortality in ICU.