To assess the associations of serum osmolality (Osm) levels with short-term outcomes in patients admitted to the intensive care unit (ICU) who received cardiac surgery. Records of ICU patients aged ≥18 years who received cardiac surgery were obtained from the intensive care database. The restricted cubic spline curves were used to assess the nonlinear correlations of serum Osm levels and short-term outcomes severe acute kidney injury (AKI), delirium, and in-hospital mortality). The multivariable Logistic regression models were used to explore the associations of serum Osm levels with severe AKI and delirium. The multivariable COX proportional hazard models were utilized to assess the relationship between serum Osm levels and in-hospital mortality. Of the total 5,788 patients, 2,406 were severe AKI, 542 were delirium, and 42 died in hospital. High serum Osm levels were associated with higher odds of severe AKI odds ratios (ORs)=1.15, 95% confidence intervals (CI): 1.01-1.32) and in-hospital mortality hazard ratios (HRs)=1.95, 95%CI: 1.05-3.64 in ICU patients who received cardiac surgery, while were not related to delirium risk. The risk of severe AKI exhibited a nonlinear "J" curve relationship with serum Osm levels. A nonlinear U-shaped correlation of serum Osm levels with delirium risk was discovered. No nonlinear association was found for in-hospital mortality, although the risk of in-hospital death appeared to increase as serum Osm levels increased. Serum Osm levels were associated with short-term outcomes in ICU patients receiving cardiac surgery. Serum Osm may be a potential risk marker in ICU care, helping to identify patients who may require closer attention to optimize fluid resuscitation protocols and intravenous hydration to prevent complications.
Song et al. (Fri,) studied this question.