Observational studyCritical care (London, England)2023
Association of autoimmune diseases with the occurrence and 28-day mortality of sepsis: an observational and Mendelian randomization study.
Observational study in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Pooled it
- Causal risk and protective factors for rheumatoid arthritis: a comprehensive mendelian randomization systematic review and meta-analysis.Frontiers in genetics · 2026Pooled it
- Pooled it
- Post-marketing safety profile of cladribine in multiple sclerosis: a disproportionality analysis based on the FDA adverse event reporting system.International journal of clinical pharmacy · 2026Article
- Sepsis in Autoimmune Rheumatic Diseases: Risk Factors, Pathophysiology, and Outcomes.Risk management and healthcare policy · 2026Review
- Evaluating the Causal Roles of Matrix Metalloproteinases in Metabolic Syndrome: A Mendelian Randomization Study Highlighting MMP12 in Blood Pressure Regulation.Genetics research · 2026Article
- Development and Validation of a 28-Day Mortality Prediction Model for Patients with Sepsis Complicated by Autoimmune Diseases Using Two Machine Learning Methods.Journal of inflammation research · 2026Article
- Mendelian randomization study of the causal relationship between autoimmune diseases and anemia using proteomic and genetic data.Journal of translational autoimmunity · 2025Article
- Enhanced insights into immunity traits of elderly patients in the intensive care unit with infections: evidence from a multicenter, prospective observational study.Critical care (London, England) · 2025Observational
- Genetic correlations and causal associations between BMI, HDL-C, and postoperative infections: a two-sample Mendelian randomization study.Scientific reports · 2025Article
- Under the background of the new global definition of ARDS: an interpretable machine learning approach for predicting 28-day ICU mortality in patients with sepsis complicated by ARDS.Frontiers in physiology · 2025Article
- Therapeutic plasma exchange in autoimmune diseases: a retrospective study in a tertiary pediatric hospital in Mexico.Frontiers in pediatrics · 2025Article
- Personalized machine learning-based prognostic model for ICU-acquired bloodstream infections.Frontiers in cellular and infection microbiology · 2025Article
- The impact of autoimmune diseases on delirium risk in critically ill patients: a propensity score matching multicenter analysis.Frontiers in medicine · 2025Article
- Impact of serum calcium levels on the occurrence of sepsis and prognosis in hospitalized patients with concomitant psoriasis: a retrospective study based on the MIMIC-IV database.Frontiers in immunology · 2025Article
- Protein palmitoylation: an emerging regulator of inflammatory signaling and diseases.Frontiers in immunology · 2025Review
- The comprehensive relationship between combined anti-inflammatory and healthy diets and all-cause mortality in rheumatoid arthritis: results from NHANES 2003-2018.Arthritis research & therapy · 2024Article
- Causal association between cystatin C and diabetic retinopathy: A two-sample Mendelian randomization study.Journal of diabetes investigation · 2024Article
- Rheumatoid arthritis increases the risk of heart failure: results from the cross-sectional study in the US population and mendelian randomization analysis in the European population.Frontiers in immunology · 2024Article
- Therapeutically Fine-Tuning Autonomic Nervous System to Treat Sepsis: A New Perspective on the Immunomodulatory Effects of Acupuncture.Journal of inflammation research · 2024Review
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundObservational studies have indicated a potential association between autoimmune diseases and the occurrence of sepsis, with an increased risk of mortality among affected patients. However, whether a causal relationship exists between the two remains unknown.
methodsIn the Mendelian randomization (MR) study, we accessed exposure Genome-wide association study (GWAS) data from both the MRC Integrative Epidemiology Unit (MRC-IEU) and the FinnGen consortium. GWAS data for sepsis and its 28-day mortality were obtained from MRC-IEU. We employed univariable, multivariable, and reverse MR analyses to explore potential associations between autoimmune disorders and sepsis and its 28-day mortality. Additionally, a two-step mediation MR analysis was performed to investigate indirect factors possibly influencing the relationship between autoimmune disorders and sepsis. Afterward, we conducted an observational analysis to further explore the relationship between autoimmune disease and occurrence as well as 28-day mortality of sepsis using a real-world database (the MIMIC-IV database). A cohort of 2537 patients diagnosed with autoimmune disease were extracted from the database for analysis. Multivariable logistic regression models were used to confirm the association between autoimmune diseases and the occurrence of sepsis, as well as the 28-day mortality associated with sepsis.
resultsIn univariable MR analysis, there appeared to be causal relationships between genetically predicted type 1 diabetes (OR = 1.036, 95% CI = 1.023-1.048, p = 9.130E-09), rheumatoid arthritis (OR = 1.077, 95% CI = 1.058-1.097, p = 1.00E-15) and sepsis, while a potential causal link was observed between celiac disease and sepsis (OR = 1.013, 95% CI = 1.002-1.024, p = 0.026). In a subsequent multivariable MR analysis, only rheumatoid arthritis was found to be independently associated with the risk of sepsis (OR = 1.138, 95% CI = 1.044-1.240, p = 3.36E-03). Furthermore, there was no causal link between autoimmune disorders and 28-day mortality from sepsis. In reverse MR analysis, sepsis was suggested to potentially trigger the onset of psoriasis (OR = 1.084, 95% CI = 1.040-1.131, p = 1.488E-04). In the real-world observational study, adjusting for multiple confounders, rheumatoid arthritis (OR = 1.34, 95% CI = 1.11-1.64, p = 0.003) and multiple sclerosis (OR = 1.31, 95% CI = 1.03-1.68, p = 0.02) were associated with a higher risk of sepsis. In addition, we did not find that autoimmune diseases were associated with 28-day mortality from sepsis.
conclusionBoth in observational and MR analysis, only rheumatoid arthritis is highly correlated with occurrence of sepsis. However, autoimmune disease was not associated with an increased 28-day mortality in patient with sepsis. Sepsis may increase the risk of developing psoriasis.
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