Frontiers in Medicine (Dec 2021)

Association Between Base Excess and Mortality Among Patients in ICU With Acute Kidney Injury

  • Yi Cheng,
  • You Zhang,
  • Boxiang Tu,
  • Yingyi Qin,
  • Xin Cheng,
  • Ran Qi,
  • Wei Guo,
  • Dongdong Li,
  • Shengyong Wu,
  • Ronghui Zhu,
  • Yanfang Zhao,
  • Yuanjun Tang,
  • Cheng Wu

DOI
https://doi.org/10.3389/fmed.2021.779627
Journal volume & issue
Vol. 8

Abstract

Read online

Objective: This study aimed to explore the association between base excess (BE) and the risk of 30-day mortality among patients with acute kidney injury (AKI) in the intensive care unit (ICU).Methods: This retrospective study included patients with AKI from the Medical Information Mart for Intensive Care (MIMIC)-IV database. We used a multivariate Cox proportional-hazards model to obtain the hazard ratio (HR) for the risk of 30-day mortality among patients with AKI. Furthermore, we utilized a Cox proportional-hazard model with restricted cubic splines (RCS) to explore the potential non-linear associations.Results: Among the 14,238 ICU patients with AKI, BE showed a U-shaped relationship with risk of 30-day mortality for patients with AKI, and higher or lower BE values could increase the risk. Compared with normal base excess (−3~3 mEq/L), patients in different groups (BE ≤ −9 mEq/L, −9 mEq/L < BE ≤ −3 mEq/L, 3 mEq/L < BE ≤ 9 mEq/L, and BE > 9 mEq/L) had different HRs for mortality: 1.57 (1.40, 1.76), 1.26 (1.14, 1.39), 0.97 (0.83, 1.12), 1.53 (1.17, 2.02), respectively. The RCS analyses also showed a U-shaped curve between BE and the 30-day mortality risk.Conclusion: Our results suggest that higher and lower BE in patients with AKI would increase the risk of 30-day mortality. BE measured at administration could be a critical prognostic indicator for ICU patients with AKI and provide guidance for clinicians.

Keywords