早期白蛋白输注与老年脓毒症患者死亡率间的关系——基于MIMIC-IV数据库分析

陈进敏; 陆远强

doi:10.1631/jzus.B2400268

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Research Article | Updated：2026-04-23

早期白蛋白输注与老年脓毒症患者死亡率间的关系——基于MIMIC-IV数据库分析
Early albumin infusion and mortality in elderly patients with sepsis based on analysis of the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database
浙江大学学报（英文版）（B辑：生物医学和生物技术） 2026年27卷第4期页码：390-401
Affiliations：

1.Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
2.Department of Emergency Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
Funds：

the National Key Research and Development Program of China(2023YFC3603100;2023YFC3603105)
DOI：10.1631/jzus.B2400268
中图分类号：
CSTR：
收稿：2024-05-26，

修回：2025-03-26，

网络首发：2026-03-21，

纸质出版：2026-04-23
Accepted：

陈进敏,陆远强.早期白蛋白输注与老年脓毒症患者死亡率间的关系——基于MIMIC-IV数据库分析[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2026,27(04):390-401.

Jinmin CHEN, Yuanqiang LU. Early albumin infusion and mortality in elderly patients with sepsis based on analysis of the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database[J]. Journal of Zhejiang University-SCIENCE B, 2026, 27(4): 390-401.
陈进敏,陆远强.早期白蛋白输注与老年脓毒症患者死亡率间的关系——基于MIMIC-IV数据库分析[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2026,27(04):390-401. DOI： 10.1631/jzus.B2400268.

Jinmin CHEN, Yuanqiang LU. Early albumin infusion and mortality in elderly patients with sepsis based on analysis of the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database[J]. Journal of Zhejiang University-SCIENCE B, 2026, 27(4): 390-401. DOI： 10.1631/jzus.B2400268.

摘要

由于早期白蛋白输注对老年脓毒症患者预后的影响尚不明确，因此本文旨在探讨早期白蛋白输注与重症监护病房（ICU）老年脓毒症患者预后间的关系。本研究从重症监护医学信息集-IV（MIMIC-IV）数据库中提取了需ICU收治的老年脓毒症患者信息，并将其分为低白蛋白血症组和对照组，主要结局为90天死亡率。采用多变量逻辑回归模型和多变量Cox比例风险模型分析低白蛋白血症与预后间的关系，并经Kaplan-Meier生存曲线和Log-rank检验分析生存结局。通过倾向性评分匹配（PSM）进一步确认早期白蛋白输注对老年ICU脓毒症患者预后的精准影响，并通过亚组分析探讨影响该关系的因素。结果表明，早期低白蛋白血症与老年脓毒症患者不良临床结局的风险呈显著相关；其住院死亡率（28.6% vs. 19.1%，

0.001）和90天死亡率（48.8% vs. 33.4%，

0.001）均显著高于对照组。此外，PSM分析显示，在伴有低白蛋白血症的老年脓毒症患者中，早期白蛋白输注与较低的住院死亡率和90天死亡率相关。综上所述，早期白蛋白输注可改善老年脓毒症患者预后，并降低其住院死亡率和90天死亡率。

Abstract

As the impact of early albumin infusion on the prognosis of elderly individuals diagnosed with sepsis remains uncertain

this study aimed to investigate this effect in elderly patients with sepsis in the intensive care unit (ICU). We identified the information of elderly patients with sepsis requiring ICU admission from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. They were divided into hypoalbuminemia group and con

trol group

and the primary outcome was 90-d mortality. A multivariate logistic regression model and a multivariate Cox proportional-hazards model were used to analyze the correlation between hypoalbuminemia and patient prognosis. Kaplan-Meier survival curve and log-rank test were performed to analyze the survival outcomes. Propensity score matching (PSM) was implemented to determine the precise effect of early albumin infusion on the prognosis of elderly ICU patients with sepsis

and subgroups of patients were identified to explore the factors influencing the relationship. Early hypoalbuminemia was strongly associated with an increased risk of adverse clinical outcomes in elderly patients with sepsis in the ICU. In-hospital mortality (28.6% vs. 19.1%

0.001) and 90-d mortality (48.8% vs. 33.4%

0.001) were both significantly higher in the early hypoalbuminemia group than in the control group. PSM analysis showed that early albumin infusion was associated with lower in-hospital mortality and 90-d mortality in elderly patients with sepsis combined with hypoalbuminemia in the ICU. Early infusion of albumin could improve patient prognosis and reduce in-hospital mortality and 90-d mortality.

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references

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