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Acidosis predicts mortality independently from hyperlactatemia in patients with sepsis

European Journal of Internal Medicine Mar 10, 2020

Wernlya B, Heramvandc N, Masyuk M, et al. - This study seeks to identify BE and pH for risk prediction capabilities in a sub-group of septic individuals in the MIMIC-III database. Researchers estimated relationships with mortality by logistic regression analysis in 5,586 septic individuals. They explored baseline parameters, lactate concentrations, pH, and BE at baseline and after 6 hours. They merged acidosis (defined as either BE ≤-6 and/or pH ≤ 7.3) and hyperlactatemia and divided the cohort into three subgroups: low-risk (no acidosis and lactate < 2.3 mmol/L; n = 2,294), medium-risk (either acidosis or lactate > 2.3 mmol/L; n = 2,125) and high-risk (both acidosis and lactate > 2.3 mmol/L; n = 1,167). It was demonstrated that acidosis and hyperlactatemia can occur independently to a certain degree. The results showed that combining acidosis and hyperlactatemia in a model produced higher predictiveness for ICU-mortality. In the future, septic individuals with acidosis should be treated even more aggressively.
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