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<p>The purpose of this study was to investigate the relationship. between serum osmolality levels and 28-day mortality in patients with DKA. Data for this observational cohort study were obtained from the MIMIC-IV3.0 database. The participants were divided into five groups based on the serum osmolality quintiles. The primary outcome was 28-day mortality. We employed Cox proportional hazards regression analysis and threshold effect analysis to assess. the relationship between serum osmolality levels and 28-day mortality in patients with DKA. The study included 1026 patients; the mean age was 52 years, 55.0% were male. Our findings indicate that serum osmolality is associated with an increased risk of 28-day mortality, exhibiting a U-shaped relationship. Altered serum osmolality levels, whether lower or higher, are linked to a heightened risk of mortality. When osmolality &lt; 306.8 mOsm/kg, the 28-day mortality risk decreased by 6.2% (HR 0.938, 95% CI 0.912–0.964) for every 1 mOsm/kg increase. At osmolality ≥ 306.8 mOsm/kg, there was a 3.7% (HR 1.037, 95% CI 1.030–1.045) increase in the 28-day mortality risk for every 1 mOsm/kg increase in osmolality. The risk of mortality was lower at osmolality of 284–299 mOsm/kg. A U-shaped correlation between initial serum osmolality and 28-. days all-cause mortality in patients with DKA was identified. These results underscore. serum osmolality’s critical role in early mortality among patients with DKA.</p>

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Association of serum osmolality levels with all-cause mortality risk in patients with DKA

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月29日

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  • Jian Liao,
  • Dingyu Lu,
  • Zhi Liang,
  • Hongwei Tan,
  • Maojuan Wang

摘要

The purpose of this study was to investigate the relationship. between serum osmolality levels and 28-day mortality in patients with DKA. Data for this observational cohort study were obtained from the MIMIC-IV3.0 database. The participants were divided into five groups based on the serum osmolality quintiles. The primary outcome was 28-day mortality. We employed Cox proportional hazards regression analysis and threshold effect analysis to assess. the relationship between serum osmolality levels and 28-day mortality in patients with DKA. The study included 1026 patients; the mean age was 52 years, 55.0% were male. Our findings indicate that serum osmolality is associated with an increased risk of 28-day mortality, exhibiting a U-shaped relationship. Altered serum osmolality levels, whether lower or higher, are linked to a heightened risk of mortality. When osmolality < 306.8 mOsm/kg, the 28-day mortality risk decreased by 6.2% (HR 0.938, 95% CI 0.912–0.964) for every 1 mOsm/kg increase. At osmolality ≥ 306.8 mOsm/kg, there was a 3.7% (HR 1.037, 95% CI 1.030–1.045) increase in the 28-day mortality risk for every 1 mOsm/kg increase in osmolality. The risk of mortality was lower at osmolality of 284–299 mOsm/kg. A U-shaped correlation between initial serum osmolality and 28-. days all-cause mortality in patients with DKA was identified. These results underscore. serum osmolality’s critical role in early mortality among patients with DKA.