Association Between VitaminE and 28-Day Mortality in adult sepsis patients: a retrospective cohort analysis

Abstract BACKGROUND There is currently no clear conclusion on the impact of isolated vitamin E in the nutritional composition on the 28-day mortality rate of adult sepsis patients. This study hypothesized that vitamin E could improve outcomes for patients with sepsis. METHODS The primary objective of this project is to evaluate the relationship between Vitamin E and 28-Day Mortality. The secondary objective is to investigate whether variations in Vitamin E administration routes lead to differences in 28-day mortality rates. We analyzed adult sepsis patients (According to the international diagnostic criteria of sepsis3.0) from the Medical Information Mart for Intensive Care IV Database (MIMIC-IV). A multivariate regression, propensity score analysis, and interaction effects, survival curve was used to determine the associations between Vitamin E intake and 28-day mortality rates in ICU. RESULTS This cohort study included 25 715 samples and 287 patients treated with the investigational drug. A significant reduction in 28-day mortality was observed among patients who used vitamin E (therapy group) compared to those who did not use it (control group) (HR = 0.71, 95% CI = 0.54~0.93, p=0.014). The adjusted Hazard Ratio was 0.62 (95% CI = 0.47~0.81, p<0.001). In the propensity score matching (PSM) model, the HR values are all <1, and the p-values are all <0.05, with consistent trends in all results. The survival curve demonstrated a significant difference in the same trend before and after propensity score matching (p=0.014). However, the 28-day mortality rate results of intravenous administration of vitamin E compared to other routes of administration is: (HR, 1.77; 95% CI, 0.97-3.21, p=0.062). CONCLUSIONS In a general population of critically ill patients with adult sepsis, use of vitamin E is associated with improved 28-day mortality in ICU. The intravenous administration of vitamin E did not demonstrate better mortality outcomes compared to other routes of administration.