Evaluating the relationship between 24-h urine output and clinical outcomes in critically injured trauma patients: a retrospective cohort study
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To investigate the relationship between urine output in the first 24 h after ICU admission and the 28-day, ICU, and hospital mortality rate in trauma patients. METHODS: Clinical data of trauma patients from the Medical Information Mart for Intensive Care IV database and the eICU Collaborative Research Database were extracted. The non-linear relationship between 24-h urine output and clinical outcomes was described using restricted cubic splines. Patients were divided into three groups (LUO, MUO, and HUO) based on their 24-h urine output, followed by pairwise propensity score matching to create three matched cohorts. To evaluate the association between urine output and clinical outcomes, we applied log-rank tests, multivariate logistic regression, inverse probability of treatment weighting (IPTW)-adjusted logistic regression, and a doubly robust estimation model. RESULTS: This study included 8,501 trauma patients from MIMIC-IV and 3,309 from the eICU database. Compared with the LUO group, the MUO group had a lower risk of 28-day mortality (OR 0.77, 95% CI 0.64-0.94, p < 0.01), and this association remained robust across multiple analytical models. However, no significant differences in 28-day mortality between the HUO and MUO groups were observed except in the log-rank test, and no strong correlation between high urine output and clinical prognosis was found in other models. CONCLUSION: In ICU-admitted trauma patients, a 24-h urine output of less than 800 mL is an independent risk factor for 28-day and ICU mortality.
Authors: Yunuo Zhao, Tao Zhang, Xi Zhong, Xuelei Ma
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,190
OpenAlex ID: W4416717401