Recommended Hematocrit in Patients With Sepsis: An Observational Study.

Background and Aims: Sepsis is a critical condition requiring optimized clinical management, especially in terms of hematocrit. The relationship between early stage of hematocrit and mortality in patients with sepsis remains underexplored. Method: This observational cohort study used data from the eICU Collaborative Research Database. Hematocrit within the first 72 h of intensive care unit (ICU) admission in patients with sepsis was analyzed. The association of hematocrit with hospital and ICU mortality was assessed using generalized additive models, and inverse probability of treatment weighting was applied to ensure the balanced distributions of variables between the groups. Results: Our analysis revealed a pivotal hematocrit threshold of 33%. Below this value, the risks of all-cause hospital and ICU mortality significantly decreased. This nonlinear association underscores the importance of maintaining hematocrit above this value. Thus, hematocrit can serve as a critical marker for predicting clinical outcomes and improving patient management in the early phase of sepsis treatment. Conclusion: Early management of hematocrit is critical in patients with sepsis; maintaining hematocrit above 33% can improve survival outcomes among these patients. These findings suggest that anemia treatment strategies in sepsis care should be re-evaluated, and they demonstrate the importance of personalized management of hematocrit for enhancing patient prognosis.