What does this research mean for the field?

Early arterial pH changes during the transition from the emergency department to the intensive care unit independently predict 28-day mortality in sepsis patients, particularly those with a normal baseline pH. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the prognostic significance of early arterial pH changes (ΔpH) during the transition from the emergency department to the intensive care unit in patients with sepsis.

September 8, 2026Shock

Early Arterial pH Changes as Strong Predictors of Mortality in Sepsis: A Multicenter Cohort Study

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Authors

JHJiwoo HanUlsan College DKDongju KimUlsan College WKWon Young KimUlsan College

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Implication

Multicenter cohort study finds early arterial pH drops predict 28-day mortality in sepsis, highlighting acute deterioration risks even among patients with normal baseline pH.

Key Points

To evaluate the prognostic significance of early arterial pH changes (ΔpH) during the transition from the emergency department to the intensive care unit in patients with sepsis.
Analyzed 3,512 patients with community-acquired sepsis admitted to the ICU within 6 hours of emergency department presentation across multiple centers (September 2019 to December 2023).
Stratified patients by baseline pH into acidosis (<7.35), normal (7.35–7.45), and alkalosis (>7.45), defining ΔpH as the change from emergency department pH to the lowest ICU pH within 24 hours.
Derived prognostic cutoffs in a 70% derivation cohort and validated 28-day mortality associations using multivariable Cox models with restricted cubic splines in an independent 30% validation cohort.
Optimal ΔpH drop thresholds associated with increased risk were identified as -0.012 for baseline acidosis, -0.145 for normal baseline pH, and -0.240 for baseline alkalosis.
In the validation cohort, ΔpH values below these thresholds independently predicted higher 28-day mortality overall (adjusted HR 2.80; 95% CI, 2.13–3.69; C-index = 0.678).
Subgroup analyses confirmed elevated mortality across baseline categories: acidosis (adjusted HR 2.71; 95% CI, 1.66–4.43), normal pH (adjusted HR 4.43; 95% CI, 2.81–7.00), and alkalosis (adjusted HR 1.90; 95% CI, 1.04–3.48).

Cite This Study

Han et al. (2026) studied this question.

synapsesocial.com/papers/6a9fd7e758e84d0ff5b47005 https://doi.org/10.1097/shk.0000000000002932

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Implication

Multicenter cohort study finds early arterial pH drops predict 28-day mortality in sepsis, highlighting acute deterioration risks even among patients with normal baseline pH.

Early Arterial pH Changes as Strong Predictors of Mortality in Sepsis: A Multicenter Cohort Study

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Implication

Key Points

Cite This Study

Early Arterial pH Changes as Strong Predictors of Mortality in Sepsis: A Multicenter Cohort Study

Discussion

Member takes

Implication

Key Points

Cite This Study

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