The Associations Between Fibrinogen and Septic Shock in Critically Ill Patients With Sepsis: A Retrospective Cohort Study.

Abstract

Background: Fibrinogen has been used as a prognostic indicator for sepsis. However, the associations of fibrinogen and septic shock in septic patients remain unclear. This study aimed to explore the relationship between fibrinogen levels and the occurrence of septic shock in patients with sepsis.

Methods: Data were retrospectively analyzed from the Medical Information Mart for Intensive Care IV (MIMIC-IV v3.1) database. The Boruta algorithm and random forest model were used for feature selection to ensure the important variables affecting results. Multivariate logistic regression assessed the association between fibrinogen and septic shock. Subgroup analysis was conducted to evaluate the impact of additional variables on the results.

Results: The study included 3302 septic patients. Fibrinogen was significantly associated with septic shock (odds ratio [OR] = 1.46; 95% confidence interval [CI], 1.35-1.56), and the risk of septic shock increased with higher fibrinogen levels (all p values for trend < 0.001). The ROC curve demonstrated the predictive accuracy of fibrinogen for septic shock in sepsis patients. After adjustment for demographics and laboratory, fibrinogen had a higher area under curve (AUC) value (0.78; 95% CI, 0.76-0.79) than SOFA (AUC, 0.58; 95% CI, 0.56-0.61), SASP II (AUC, 0.67; 95% CI, 0.65-0.69), and APS II (AUC, 0.69; 95% CI, 0.68-0.71).

Conclusion: A linear relationship was found between fibrinogen levels and septic shock. Elevated fibrinogen levels were linked to a higher risk of septic shock in septic patients.