Association between base excess and mortality in septic older adults

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International Pub Date : 2025-01-20 DOI:10.1111/ggi.15080

Qiang Zhou, Yuxiu Miao, Fenghua Li, Jianhua Liu, Jianing Li, Na Li

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引用次数: 0

Abstract

Aim

Septic older adults represent a vulnerable population with high mortality rates. Base excess (BE), an indicator of acid–base status, may serve as a prognostic marker in sepsis.

This study aimed to investigate the association between BE and mortality in septic older adults.

Methods

A retrospective analysis included septic older adults (age ≥ 65 years) from the Medical Information Mart for Intensive Care (MIMIC)-IV database. The primary outcome was 30-day mortality. Multivariate Cox regression models and Kaplan–Meier analysis were used to assess the association between BE and 30-day mortality. A two-segment linear regression model with smooth curve fitting was employed to examine threshold effects of BE on clinical outcomes.

Results

The study comprised 7379 participants, with a 21.8% 30-day mortality rate and an 18.6% in-hospital mortality rate. A nonlinear, U-shaped relationship (P < 0.001) was observed between BE and 30-day mortality in septic older adults, indicating increased risk with higher or lower BE levels. Various BE groups showed different hazard ratios for mortality: 2.7 (2.26–3.22), 1.86 (1.65–2.09), 1.41 (1.19–1.67), and 1.9 (1.4–2.58), respectively, compared with the reference group (−3 mEq/L ≤ BE < 3 mEq/L). The inflection point was calculated as 0.5 mEq/L.

Conclusions

Our findings suggest a U-shaped relationship between BE and mortality in septic older adults, emphasizing the importance of monitoring acid–base status in sepsis management for this population. Geriatr Gerontol Int 2025; 25: 380–386.

Abstract Image

查看原文本刊更多论文

脓毒症老年人碱过量与死亡率之间的关系。

目的：感染性老年人是死亡率高的弱势群体。碱过量（BE），酸碱状态的一个指标，可作为脓毒症的预后标志。本研究旨在探讨感染性老年人BE与死亡率之间的关系。方法：回顾性分析重症监护医学信息市场(MIMIC)-IV数据库中败血症老年人（年龄≥65岁）。主要终点为30天死亡率。采用多变量Cox回归模型和Kaplan-Meier分析评估BE与30天死亡率之间的关系。采用光滑曲线拟合的两段线性回归模型检验BE对临床预后的阈值效应。结果：该研究包括7379名参与者，30天死亡率为21.8%，住院死亡率为18.6%。结论：我们的研究结果表明，在脓毒症老年人中，BE与死亡率呈u型关系，强调了监测酸碱状态在脓毒症管理中的重要性。Geriatr Gerontol 2025；••: ••-••.

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Geriatrics & Gerontology International 医学-老年医学

CiteScore

5.50

自引率

6.10%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Geriatrics & Gerontology International is the official Journal of the Japan Geriatrics Society, reflecting the growing importance of the subject area in developed economies and their particular significance to a country like Japan with a large aging population. Geriatrics & Gerontology International is now an international publication with contributions from around the world and published four times per year.