Observational studyShock (Augusta, Ga.)2026
Ulinastatin Treatment Associated with Lower Sepsis-Associated Encephalopathy Risk in Sepsis Patients: A Multicenter Observational Study.
Observational study in Shock (Augusta, Ga.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
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Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundUlinastatin, widely used in Asia for sepsis management, lacks a comprehensive evaluation regarding its efficacy in preventing sepsis-associated encephalopathy (SAE). This study investigates ulinastatin's association with SAE incidence and explores combined biomarkers for early SAE prediction.
methodsThis study employed a dual-cohort design involving 2,200 sepsis patients from a multicenter retrospective cohort and an independent validation cohort of 534 patients from a single-center prospective study. Using logistic regression and propensity score matching, we assessed the association between ulinastatin treatment and SAE incidence in the retrospective cohort. The findings were subsequently validated in the prospective cohort. We also evaluated clinical outcomes in ulinastatin-treated patients and examined the predictive utility of combining nitric oxide levels with key clinical indicators-including fasting blood glucose/high-density lipoprotein cholesterol ratio, Sequential Organ Failure Assessment score, and lactate levels-for early SAE risk stratification.
resultsIn the retrospective cohort, both univariate (odds ratio [OR] 0.618, 95% confidence interval [CI] 0.472-0.811; P = 0.001) and multivariate analyses (OR 0.603, 95% CI 0.453-0.802; P < 0.001) demonstrated that ulinastatin administration was significantly associated with reduced SAE risk. Propensity score matching confirmed this protective relationship. The prospective validation cohort similarly showed ulinastatin treatment was independently associated with lower SAE incidence (adjusted OR 0.491; 95% CI 0.302-0.800; P = 0.004). While individual biomarkers (nitric oxide, fasting blood glucose/high-density lipoprotein cholesterol, Sequential Organ Failure Assessment, and lactate) showed limited predictive value (all area under the receiver operating characteristic curves <0.70), their combination significantly improved SAE prediction accuracy, achieving a maximum area under the receiver operating characteristic curve of 0.726.
conclusionsUlinastatin treatment is significantly associated with reduced SAE incidence in sepsis patients, offering novel insights and potential therapeutic strategies for preventing SAE and improving neurological outcomes.
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