脓毒症患者碱剩余与28天死亡率之间的关联：基于MIMIC-IV数据库的二次分析
Association between base excess and 28-day mortality in sepsis patients: A secondary analysis based on the MIMIC- IV database.
作者信息
Yuan Jia, Liu Xu, Liu Ying, Li Wei, Chen Xianjun, Chen Qiming, Xiao Chuan, Wan Ying, Li Shuwen, Li Qing, Li Lu, He Juan, Chen Lu, Shen Feng
机构信息
Department of Intensive Care Unit, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550001, Guizhou Province, China.
Department of Good Clinical Practice, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550001, Guizhou Province, China.
出版信息
Heliyon. 2023 May 9;9(5):e15990. doi: 10.1016/j.heliyon.2023.e15990. eCollection 2023 May.
OBJECTIVE
The relationship between base excess (BE) and 28-day death in sepsis patients remains to be elucidated. The aim of our clinical study is to explore the association of BE with 28-day mortality in patients with sepsis by using a large sample, multicenter Medical Information Mart for Intensive Care IV (MIMIC-IV) database.
METHODS
We extracted the data of 35,010 patients with sepsis from the MIMIC-IV database, in which we used BE as an exposure variable and the 28-day mortality as an outcome variable, respectively, so as to explore the impact of BE on the 28-day mortality of patients with sepsis after adjusting for covariates.
RESULTS
BE and the 28-day mortality of patients with sepsis appeared to have a U-shaped relationship. The calculated inflection points were -2.5 mEq/L and 1.9 mEq/L, respectively. Our data demonstrated that BE was negatively associated with 28-day mortality in the range of -41.0 mEq/L to -2.5 mEq/L (odds ratio: 0.95; 95% confidence intervals (95%CI): 0.93 to 0.96), < 0.0001. When BE was in the range of 1.9 mEq/L to 55.5 mEq/L, however, a positive association existed between BE and 28-day mortality of patients with sepsis (odds ratio: 1.03; 95% CI: 1.00 to 1.05; < 0.05).
CONCLUSION
The BE levels have a U-shaped relationship with the 28-day mortality in patients with sepsis, in which the mortality of patients will gradually decrease with a BE value from -41.0 mEq/L to -2.5 mEq/L, while the mortality will increase with a BE value from 1.9 mEq/L to 55.5 mEq/L.
目的
脓毒症患者碱剩余（BE）与28天死亡率之间的关系仍有待阐明。我们临床研究的目的是通过使用大型多中心重症监护医学信息数据库IV（MIMIC-IV），探讨脓毒症患者中BE与28天死亡率的关联。
方法
我们从MIMIC-IV数据库中提取了35010例脓毒症患者的数据，分别将BE作为暴露变量，28天死亡率作为结局变量，以探讨在调整协变量后BE对脓毒症患者28天死亡率的影响。
结果
脓毒症患者的BE与28天死亡率呈U形关系。计算出的拐点分别为-2.5 mEq/L和1.9 mEq/L。我们的数据表明，在-41.0 mEq/L至-2.5 mEq/L范围内，BE与28天死亡率呈负相关（比值比：0.95；95%置信区间（95%CI）：0.93至0.96，<0.0001）。然而，当BE在1.9 mEq/L至55.5 mEq/L范围内时，BE与脓毒症患者的28天死亡率呈正相关（比值比：1.03；95%CI：1.00至1.05；<0.05）。
结论
BE水平与脓毒症患者的28天死亡率呈U形关系，其中BE值从-41.0 mEq/L至-2.5 mEq/L时患者死亡率逐渐降低，而BE值从1.9 mEq/L至55.5 mEq/L时死亡率升高。
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