Impact of pre-ICU balanced crystalloids versus saline on mortality in sepsis: a propensity score-matched multicenter cohort study
Main finding · 30-day mortalityResult — go to the resultAdjusted odds ratio 0.69 95% CI 0.56–0.83Authors' conclusion
Pre-ICU administered balanced crystalloid use was associated with lower 30-day mortality in patients with sepsis than saline.
Study context
- Population
- Adults with sepsis receiving initial fluid resuscitation before intensive care unit (ICU) admission, September 2019–December 20231,335 per group matched
- Participants
- 3,688 adults
- Exposure
- Pre-ICU balanced crystalloids vs saline
- Balanced crystalloidn = 1,381
- Salinen = 2,307reference
- Outcome
- 30-day mortality
- Follow-up
- 30 days
Methodological detailsnationwide multicentre, propensity-score matched, inverse probability of treatment weighting
- Nationwide multicentre
- Propensity-score matched
- Inverse probability of treatment weighting
Main finding
As reported in the abstract
Adjusted odds ratio
0.69
95% CI 0.56–0.83
Balanced crystalloid vs Saline
aOR 0.69 (95% CI 0.56–0.83)
Observational data: associations, not effects.
Further findings
30-day mortality, inverse probability of treatment weighting (sensitivity analysis)
- Finding consistent after inverse probability of treatment weighting: aOR
- 0.78 (95% CI 0.69-0.88)
30-day mortality by subgroup (subgroup)
- Association consistent across age, sex, disease severity, liberal fluid management (pre-ICU fluid volume >30 mL/kg) and pre-ICU vasopressor use
- Lower mortality risk with balanced crystalloids in patients without CKD, fluids in ED or ward (vs operating room or other ICU), baseline chloride ≤110 mmol/L and baseline pH <7.35
Renal replacement therapy and ventilator-free days
- Balanced crystalloids associated with reduced need for CRRT during ICU stay, reduced RRT at ICU discharge and increased 28-day ventilator-free days
Original publication
Impact of pre-ICU balanced crystalloids versus saline on mortality in sepsis: a propensity score-matched multicenter cohort study. Chest. Published 19 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →