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.