Key result
Low admission serum bicarbonate (< 22 mmol/L) was a significant risk predictor of all-cause mortality up to 5 years in ICU patients with acute aortic dissection (AUC 0.60-0.69).
Why the study?
Serum bicarbonate level is strongly related to multiple cardiovascular complications, but no study had evaluated its prognostic ability in ICU patients with acute aortic dissection.
Does low admission serum bicarbonate predict all-cause mortality in ICU patients with acute aortic dissection?
Observational (n=336)
Does low admission serum bicarbonate predict all-cause mortality in ICU patients with acute aortic dissection?
Low admission serum bicarbonate (< 22 mmol/L) is a significant predictor of short- and long-term mortality in ICU patients with acute aortic dissection.
May aid risk stratification in acute aortic dissection; leaves open causal validation and therapeutic trials.
Objective: Serum bicarbonate (HCO3 − ) level is strongly related to multiple cardiovascular complications. Currently, there is no study evaluating the prognostic ability of serum HCO3 − level in intensive care unit (ICU) patients with acute aortic dissection (AAD). Hence, this study was to assess the relationship between admission serum HCO3 − level and clinical outcomes in patients with AAD. Design, Settings and Participants: Clinical data were extracted from the MIMIC-III database. Cox proportional hazards models and Kaplan–Meier (KM) survival curve were used to evaluate the association between serum HCO3 − levels and short- and long-term mortality in ICU patients with AAD. The subgroup analysis and the receiver operating characteristic (ROC) curve analysis and further KM survival curve based on best cut-off value were applied to assessment of the performance of HCO3 − in predicting the mortality in each period (30 days, 90 days, 1 year and 5 years). Main Results: Firstly, 336 eligible patients were trisected to low-HCO3 − level group (< 22 mmol/L), mid-HCO3 − level group (22– 24 mmol/L) and high-HCO3 − level group (> 24 mmol/L). Then, in multivariate analysis, the serum HCO3 − of low levels (< 22 mmol/L) was a significant risk predictor of all-cause mortality in 30 days, 90 days, 1 year and 5 years. Subgroup analyses indicated that there is no interaction in most strata. Finally, areas under ROC curve ranged from 0.60 to 0.69. Conclusion: The low HCO3 − serum level measured at ICU admission significantly predicts short-term and long-term mortality in AAD patients.
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Tan et al. (2021) conducted an observational in Acute aortic dissection (n=336). Low admission serum bicarbonate (< 22 mmol/L) vs. Mid (22-24 mmol/L) and high (> 24 mmol/L) serum bicarbonate levels was evaluated on All-cause mortality at 30 days, 90 days, 1 year, and 5 years. Low admission serum bicarbonate (< 22 mmol/L) was a significant risk predictor of all-cause mortality up to 5 years in ICU patients with acute aortic dissection (AUC 0.60-0.69).
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