Association between base excess and 28-day mortality in sepsis patients: A secondary analysis based on the MIMIC- IV...

Area of Science:

• Critical Care Medicine
• Biochemistry
• Epidemiology

Background:

• Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
• The prognostic value of base excess (BE) in sepsis patients requires further elucidation.
• Understanding the relationship between BE and mortality is crucial for optimizing sepsis management.

Purpose of the Study:

• To investigate the association between base excess (BE) and 28-day mortality in a large cohort of sepsis patients.
• To explore the potential U-shaped relationship between BE levels and sepsis-related mortality.
• To identify critical BE thresholds influencing patient outcomes.

Main Methods:

• Utilized a large, multicenter dataset from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.
• Included 35,010 patients diagnosed with sepsis.
• Analyzed base excess as the primary exposure variable and 28-day mortality as the outcome, adjusting for relevant covariates.

Main Results:

• A significant U-shaped relationship was observed between BE and 28-day mortality in sepsis patients.
• BE levels between -41.0 mEq/L and -2.5 mEq/L were negatively associated with mortality (OR: 0.95; 95% CI: 0.93–0.96; p < 0.0001).
• BE levels between 1.9 mEq/L and 55.5 mEq/L were positively associated with mortality (OR: 1.03; 95% CI: 1.00–1.05; p < 0.05).

Conclusions:

• Base excess exhibits a U-shaped association with 28-day mortality in sepsis.
• Mortality risk decreases with BE values from -41.0 mEq/L to -2.5 mEq/L.
• Mortality risk increases with BE values from 1.9 mEq/L to 55.5 mEq/L, highlighting potential risks at both extremes.