Effects of Serum Iron and Antithrombin-Ⅲ on the Prognosis of Multiple Organ Dysfunction Syndrome Patients in Sepsis

FU Junjing; ZHANG Jianxin

doi:10.3969/j.issn.1004-437X.2026.15.002

Abstract：Objective To investigate the effects of serum iron and antithrombin-Ⅲ(AT-Ⅲ)on the prognosis of multiple organ dysfunction syndrome(MODS)in sepsis.Methods A total of 165 patients with sepsis MODS admitted to the First Affiliated Hospital of Henan Medical University from March 2021 to February 2024 were retrospectively analyzed and divided into a death group(43 cases)and a survival group(122 cases)according to the 14-day prognosis.The baseline data,serum iron and AT-Ⅲ levels of the two groups were compared,and the effects of serum iron and AT-Ⅲ on the prognosis of sepsis MODS were analyzed by logistic regression.The subjects were divided into Q1,Q2,Q3 and Q4 groups according to the quartiles of serum iron concentration.The levels of AT-Ⅲ in patients with different serum iron levels were compared,and the correlation between serum iron and AT-Ⅲ levels was analyzed.The interactive effects of serum iron and AT-Ⅲ on the prognosis and predictive efficiency of sepsis MODS were evaluated.Results The scores of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ)and sepsis-related organ failure assessment(SOFA)in the death group were higher than those in the survival group(P＜0.05).Serum iron and AT-Ⅲ in the death group were lower than those in the survival group(P＜0.05).Logistic regression analysis before correction showed that APACHE Ⅱ score,SOFA score,serum iron and AT-Ⅲ were correlated with the prognosis of sepsis MODS(P＜0.05).After correction,serum iron and AT-Ⅲ were still correlated with the prognosis of sepsis MODS(P＜0.05).AT-Ⅲ increased in patients with Q1,Q2,Q3 and Q4,and the pairwise comparisons had statistical significance(P＜0.05).Serum iron was positively correlated with AT-Ⅲ(r=0.609,P＜0.05).The interaction of serum iron and AT-Ⅲ on the prognosis of sepsis MODS met the submultiplication model and had a positive interaction.The area under the curve(AUC)of serum iron and AT-Ⅲ combined to predict the prognosis of MODS in sepsis was 0.939,which was higher than that of serum iron and AT-Ⅲ alone(Z=3.256,3.066,P=0.001,0.002).Conclusion There is a certain correlation between serum iron and AT-Ⅲ and the prognosis of sepsis MODS patients.Low levels of both can synergistically affect the prognosis of sepsis MODS.The combination of serum iron and AT-Ⅲ has high reference value in predicting the prognosis of sepsis MODS.