Objective:

To identify distinct subtypes of early ICU serum creatinine trajectories among patients with sepsis and T2DM, assess the independent association between each identified trajectory subtype and 28-day all-cause mortality, and examine whether continuous CRRT moderates this association.

Approach:

Key Findings:

• Identified three serum creatinine trajectory patterns: low-stable, moderate-increasing, and persistently high.
• Patients in the moderate-increasing and persistently high groups had significantly elevated 28-day mortality risk compared to the low-stable group (model 2: HR = 1.50, 95% CI: 1.16-1.93, p = 0.02; model 3: HR = 1.46, 95% CI: 1.04-2.05, p = 0.03).
• The association between higher creatinine levels and mortality risk remained significant after multivariable adjustments.
• RCS analysis indicated a significant nonlinear association between serum creatinine levels and mortality risk.
• CRRT may exert a partial mediating effect on the association between creatinine elevation and mortality risk.

Interpretation:

The early trajectory of serum creatinine changes following ICU admission is associated with 28-day mortality in critically ill patients with sepsis complicated by T2DM.

Limitations:

• Study limited to data from a single database (MIMIC-IV), which may affect generalizability.
• Observational nature of the study may introduce confounding factors not accounted for.

Conclusion:

Sustained higher serum creatinine levels are associated with an increased risk of mortality.

Attribution Notice

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.