Association between estimated pulse wave velocity and the risk of mortality in patients with sepsis patients: A cohort study

Objective Sepsis remains a primary contributor to mortality among critically ill individuals, and the assessment of vascular stiffness, indicated by estimated pulse wave velocity (ePWV), could offer insights into patient outcomes. This retrospective cohort study examines the correlation between ePWV levels and all-cause mortality in individuals with sepsis. Methods A total of 22,166 sepsis patients from the MIMIC-IV database were included. Cox regression analysis, restricted cubic spline (RCS) analysis, and subgroup analyses were conducted to evaluate the association between ePWV and 30-day and 365-day mortality. Results The 30-day and 365-day mortality rates were 18.28% and 32.93%, respectively. Compared to the first quartile (Q1), patients in the highest ePWV quartile (Q4) had a 92% higher risk of 30-day mortality (HR: 1.92, 95% CI: 1.73–2.13, p < 0.001) and an 75% higher risk of 365-day mortality (HR: 1.75, 95% CI: 1.62–1.89, p < 0.001) in adjusted models. RCS analysis identified a nonlinear association between ePWV and mortality ( p for non-linearity < 0.001) with inflection points at 9.04 m/s for 30-day mortality and 10.81 m/s for 365-day mortality. The nomogram model demonstrated good performance in predicting both 30-day and 365-day mortality, with area under the curve values of 0.736 and 0.775 in the training set, respectively. Conclusions This study demonstrates that higher ePWV is significantly associated with increased short- and long-term mortality risk in critically ill sepsis patients, with evidence of a nonlinear relationship. ePWV may serve as a valuable prognostic marker to identify sepsis patients at higher risk of mortality in the ICU.