Abstract
Background
Total serum bilirubin (TBIL) levels are a risk factor in critically ill patients.
However, the relationship between the dynamics of TBIL and the prognosis of acute
respiratory failure (ARF) patients is unclear.
Objectives
This study aimed to investigate the impact of different levels of TBIL during hospitalization
on mortality in ARF patients.
Methods
This study used a retrospective cohort study. We extracted information on ARF patients
from the Medical Information Bank for Intensive Care (MIMIC)-III (version 1.4). We
used propensity score matching (PSM) to adjust for the level of potential baseline-level
differences between groups. Cox regression was used to analyze mortality risk factors
in patients with ARF. Subgroup analysis was used to explore special populations.
Results
2673 patients were included in the study, and 19.7% developed hyperbilirubinemia (TBIL
≥ 2 mg/dL) during their hospitalization. After PSM, multivariate Cox regression showed
a 50% and 135% increased risk of death for a maximum value of TBIL ≥ 5 mg/dL and minimum
value of TBIL ≥ 2 mg/dL during hospitalization, respectively, compared to the control
population. In addition, age ≥ 65 years, previous comorbid malignancies, respiratory
rate ≥ 22 beats/min, SpO2 ≥ 95, BUN ≥ 20 mg/dL, lactate ≥ 5 mmol/L, platelet < 100
* 10 ^ 9/L were independent risk factors for 1-year mortality in ARF patients. Subgroup
analysis showed that high bilirubin had a greater effect on patients aged less than
65 years (P for interaction < 0.05).
Conclusions
Hyper TBIL (TBIL max ≥ 5 mg/dL or TBIL min ≥ 2 mg/dL) was an independent risk factor
for 1-year mortality in patients with ARF. This study suggests that clinicians should
be aware of TBIL levels and intervene early in these patients.
Keywords
Abbreviations:
Acute respiratory failure (ARF), Intensive care unit (ICU), Acute respiratory distress syndrome (ARDS), Total serum bilirubin (TBIL), Medical Information Bank for Intensive Care (MIMIC), White blood cell (WBC), Blood urea nitrogen (BUN), Peripheral oxygen saturation (SpO2), Congestive heart failure (CHF), Propensity score matching (PSM)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 17, 2022
Accepted:
August 8,
2022
Received in revised form:
August 4,
2022
Received:
April 26,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
