Association between serum bicarbonate and 28-day mortality in critically ill patients with infective endocarditis: a cohort study from MIMIC-IV
Abstract The relationship between bicarbonate level and mortality in critically sick patients with infective endocarditis (IE) is currently not well established. The MIMIC-IV database was used to provide data for a retrospective cohort research. Included were patients with IE who were hospitalized t...
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2025-01-01
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| author | Yingxiu Huang Ting Ao Peng Zhen Ming Hu |
| author_facet | Yingxiu Huang Ting Ao Peng Zhen Ming Hu |
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| description | Abstract The relationship between bicarbonate level and mortality in critically sick patients with infective endocarditis (IE) is currently not well established. The MIMIC-IV database was used to provide data for a retrospective cohort research. Included were patients with IE who were hospitalized to the critical care unit (ICU). Within the first 24 h following ICU admission, the serum bicarbonate was assessed. The 28-day mortality was the end-point result. To evaluate the relationship between the serum bicarbonate and 28-day mortality, multivariable Cox regression was employed. The study included 450 patients with IE in serious condition in the ICU, with a 57.4-year-old average and 64.2% male representation. The 28-day mortality rate stood at 20%. Unadjusted analysis revealed that higher serum bicarbonate levels upon ICU admission were significantly linked to reduced 28-day mortality (hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.85–0.95; p < 0.001). This correlation remained significant after adjusting for potential confounding factors (adjusted HR, 0.94; 95% CI 0.89–0.99; p = 0.028). When categorizing bicarbonate levels, patients in the highest group (T3, ≥ 25 mEq/L) showed a significantly decreased adjusted HR of 0.55 (95% CI 0.33–0.93; p < 0.001) in relation to the control group (T1, ≤ 22 mEq/L) in the final model. Consistent results were observed in subgroup analyses across various groups. In patients with IE in the ICU, elevated serum bicarbonate upon admission was independently linked to a lower 28-day mortality. These findings indicate that serum bicarbonate can serve as a prognostic marker, supporting the process of risk assessment and providing direction for the clinical care of patients with IE. |
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| institution | Kabale University |
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| spelling | doaj-art-0ff0d6f5a91343ec856e1ce5dcddc64f2025-01-05T12:16:50ZengNature PortfolioScientific Reports2045-23222025-01-011511910.1038/s41598-024-84385-1Association between serum bicarbonate and 28-day mortality in critically ill patients with infective endocarditis: a cohort study from MIMIC-IVYingxiu Huang0Ting Ao1Peng Zhen2Ming Hu3Department of Infectious Disease, Beijing Luhe Hospital, Capital Medical UniversityDepartment of Infectious Disease, Beijing Luhe Hospital, Capital Medical UniversityDepartment of Infectious Disease, Beijing Luhe Hospital, Capital Medical UniversityDepartment of Infectious Disease, Beijing Luhe Hospital, Capital Medical UniversityAbstract The relationship between bicarbonate level and mortality in critically sick patients with infective endocarditis (IE) is currently not well established. The MIMIC-IV database was used to provide data for a retrospective cohort research. Included were patients with IE who were hospitalized to the critical care unit (ICU). Within the first 24 h following ICU admission, the serum bicarbonate was assessed. The 28-day mortality was the end-point result. To evaluate the relationship between the serum bicarbonate and 28-day mortality, multivariable Cox regression was employed. The study included 450 patients with IE in serious condition in the ICU, with a 57.4-year-old average and 64.2% male representation. The 28-day mortality rate stood at 20%. Unadjusted analysis revealed that higher serum bicarbonate levels upon ICU admission were significantly linked to reduced 28-day mortality (hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.85–0.95; p < 0.001). This correlation remained significant after adjusting for potential confounding factors (adjusted HR, 0.94; 95% CI 0.89–0.99; p = 0.028). When categorizing bicarbonate levels, patients in the highest group (T3, ≥ 25 mEq/L) showed a significantly decreased adjusted HR of 0.55 (95% CI 0.33–0.93; p < 0.001) in relation to the control group (T1, ≤ 22 mEq/L) in the final model. Consistent results were observed in subgroup analyses across various groups. In patients with IE in the ICU, elevated serum bicarbonate upon admission was independently linked to a lower 28-day mortality. These findings indicate that serum bicarbonate can serve as a prognostic marker, supporting the process of risk assessment and providing direction for the clinical care of patients with IE.https://doi.org/10.1038/s41598-024-84385-1Infective endocarditisIEBicarbonateMIMIC-IVMortality |
| spellingShingle | Yingxiu Huang Ting Ao Peng Zhen Ming Hu Association between serum bicarbonate and 28-day mortality in critically ill patients with infective endocarditis: a cohort study from MIMIC-IV Scientific Reports Infective endocarditis IE Bicarbonate MIMIC-IV Mortality |
| title | Association between serum bicarbonate and 28-day mortality in critically ill patients with infective endocarditis: a cohort study from MIMIC-IV |
| title_full | Association between serum bicarbonate and 28-day mortality in critically ill patients with infective endocarditis: a cohort study from MIMIC-IV |
| title_fullStr | Association between serum bicarbonate and 28-day mortality in critically ill patients with infective endocarditis: a cohort study from MIMIC-IV |
| title_full_unstemmed | Association between serum bicarbonate and 28-day mortality in critically ill patients with infective endocarditis: a cohort study from MIMIC-IV |
| title_short | Association between serum bicarbonate and 28-day mortality in critically ill patients with infective endocarditis: a cohort study from MIMIC-IV |
| title_sort | association between serum bicarbonate and 28 day mortality in critically ill patients with infective endocarditis a cohort study from mimic iv |
| topic | Infective endocarditis IE Bicarbonate MIMIC-IV Mortality |
| url | https://doi.org/10.1038/s41598-024-84385-1 |
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