Estimated plasma volume status exhibited a U-shaped relationship with 1-month all-cause mortality in critically ill patients with non-traumatic subarachnoid hemorrhage, with each unit increase above 3.94 associated with a 1.8-fold increased risk of death (HR 2.80).
Cohort (n=750)
No
Does estimated plasma volume status affect all-cause mortality in critically ill adult patients with non-traumatic subarachnoid hemorrhage?
In critically ill patients with non-traumatic subarachnoid hemorrhage, estimated plasma volume status exhibits a U-shaped association with 1-month mortality, suggesting both hypovolemia and hypervolemia portend poor prognosis.
Effect estimate: HR 2.80 (95% CI 1.58-4.97)
p-value: p=<0.001
Background: The estimated plasma volume status (ePVS) is an independent risk factor for poor prognosis in certain cardiovascular disease populations. However, the relationship between ePVS and prognosis in critically ill patients with non-traumatic subarachnoid hemorrhage (NSAH) remains unclear. This study aims to explore the association between ePVS and all-cause mortality (ACM) in NSAH patients. Methods: A total of 750 NSAH patients were included in this retrospective study. The primary outcome was 1-month ACM. A Cox proportional hazards model was constructed to examine the relationship between ePVS and ACM in critically ill NSAH patients. A restricted cubic spline model was used to assess the relationship between ePVS and the outcome. Results: In this patient cohort, 1-month, 3-month, and 1-year ACM rates were 21%, 25%, and 29%, respectively. After adjusting for potential confounders, we found a U-shaped relationship between ePVS and 1-month ACM, with an inflection point at 3.94. Specifically, when ePVS is below the inflection point, each unit increase in ePVS reduces the mortality risk by 56% HR, 0.44 (95% CI 0.25, 0.76). However, once the inflection point is surpassed, each unit increase in ePVS increases the mortality risk by 1.8 times HR, 2.80 (95% CI 1.58, 4.97). Conclusion: We identified a U-shaped relationship between ePVS and ACM in critically ill patients with NSAH, suggesting both low and high ePVS levels may portend adverse outcomes. Prospective multicenter studies are warranted to validate these findings and elucidate underlying mechanisms.
Mei et al. (2026) conducted a cohort in Non-traumatic subarachnoid hemorrhage (NSAH) (n=750). Estimated plasma volume status (ePVS) was evaluated on 1-month all-cause mortality (per unit increase in ePVS > 3.94) (HR 2.80, 95% CI 1.58-4.97, p=<0.001). Estimated plasma volume status exhibited a U-shaped relationship with 1-month all-cause mortality in critically ill patients with non-traumatic subarachnoid hemorrhage, with each unit increase above 3.94 associated with a 1.8-fold increased risk of death (HR 2.80).