Association of the ROX index with mortality in sepsis patients: a retrospective study.

Background: This study aims to explore the association between the ROX index and clinical outcomes in patients with sepsis. Methods: Data were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, including adult sepsis patients admitted to the intensive care unit (ICU). The primary outcome was 28-day mortality, while secondary outcomes included 7-day and 14-day mortality, ICU mortality, ICU length of stay (LOS), and hospital LOS. Restricted cubic spline models and Cox regression models were used to assess the associations between the ROX Index and clinical outcomes. Results: A total of 23,502 sepsis patients were included, who were stratified into high (ROX ≥ 6.46) and low ROX (ROX < 6.46) strata using a data-derived threshold survival analysis. In the unadjusted model, the high ROX stratum exhibited a significantly lower risk of 28-day mortality (HR = 0.33, 95% CI: 0.31-0.35, Conclusion: In patients with sepsis, a higher ROX index is associated with significantly lower mortality rates and shorter ICU and hospital stays. However, the ROX index demonstrated moderate predictive accuracy.