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Association between base excess and mortality in septic older adults
Qiang Zhou1, Yuxiu Miao2, Fenghua Li3
1Department of Orthopedic Surgery, Hekou District People's Hospital, Dongying City, China.
Geriatrics & Gerontology International
|January 20, 2025
Summary
Base excess (BE) in older adults with sepsis shows a U-shaped association with mortality. Both high and low BE levels increase the risk of death, highlighting the importance of monitoring acid-base balance.
Area of Science:
- Geriatric Medicine
- Critical Care Medicine
- Biochemistry
Background:
- Septic older adults face high mortality rates.
- Acid-base status, indicated by base excess (BE), is a potential prognostic marker in sepsis.
Purpose of the Study:
- To investigate the association between base excess (BE) and mortality in older adults with sepsis.
- To explore the prognostic value of BE in this vulnerable population.
Main Methods:
- Retrospective analysis of septic older adults (≥65 years) from the MIMIC-IV database.
- Assessment of 30-day mortality using multivariate Cox regression and Kaplan-Meier analysis.
- Examination of threshold effects using a two-segment linear regression model with smooth curve fitting.
Main Results:
- A total of 7379 participants were included, with a 30-day mortality rate of 21.8%.
- A significant U-shaped relationship was found between BE and 30-day mortality (P < 0.001).
- Both higher and lower BE levels were associated with increased mortality risk, with an inflection point at 0.5 mEq/L.
Conclusions:
- A U-shaped relationship exists between BE and mortality in septic older adults.
- Monitoring acid-base status, specifically BE, is crucial for sepsis management in the elderly.
- BE can serve as an important prognostic marker for mortality in this patient group.
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