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

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

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.779627

DOI=10.3389/fmed.2021.779627

ISSN=2296-858X

ABSTRACT=<p><bold>Objective:</bold> 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).</p><p><bold>Methods:</bold> 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.</p><p><bold>Results:</bold> 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 &lt; BE ≤ −3 mEq/L, 3 mEq/L &lt; BE ≤ 9 mEq/L, and BE &gt; 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.</p><p><bold>Conclusion:</bold> 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.</p>