Effectiveness of sodium bicarbonate infusion on mortality for elderly septic patients with acute metabolic acidosis
Objective: This study aimed to explore the effectiveness of sodium bicarbonate (SB) infusion on mortality in elderly septic patients with acute metabolic acidosis (MA) and in other subgroups.Methods: Retrospective analysis of a large ICU database (MIMIC-IV) was performed. Elderly septic patients wit...
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| Format: | Article |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.974271/full |
| _version_ | 1811209591017439232 |
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| author | Sai Huang Sai Huang Yaojun Peng Lili Wang Jing Wang Xuan Zhou Xiang Cui Li Chen Bo Yang Cong Feng Cong Feng Cong Feng Cong Feng |
| author_facet | Sai Huang Sai Huang Yaojun Peng Lili Wang Jing Wang Xuan Zhou Xiang Cui Li Chen Bo Yang Cong Feng Cong Feng Cong Feng Cong Feng |
| author_sort | Sai Huang |
| collection | DOAJ |
| description | Objective: This study aimed to explore the effectiveness of sodium bicarbonate (SB) infusion on mortality in elderly septic patients with acute metabolic acidosis (MA) and in other subgroups.Methods: Retrospective analysis of a large ICU database (MIMIC-IV) was performed. Elderly septic patients with acute MA were identified from MIMIC-IV. Propensity score analysis (PSA) was performed to explain for the baseline differences in the probability to receive SB or not. The marginal structural Cox model (MSCM) was developed to adjust for both baseline and time-varying confounding variables. The primary outcome was the ICU and hospital mortality.Results: A total of 869 elderly septic patients with acute MA were identified in this study, including 361 in the SB group and 508 in the non-SB group. In the PSA, SB infusion was not associated with reduced ICU (HR 0.82, 95% CI 0.62–1.10; p = 0.19) or hospital (HR 0.94, 95% CI 0.74–1.19; p = 0.60) mortality in overall elderly septic patients with acute MA. In the subgroup of severe metabolic acidosis, SB infusion could not improve the ICU (HR 0.82, 95% CI 0.62–1.10; p =0.19) and hospital (HR 0.94, 95% CI 0.74–1.19; p =0.60) mortality on elderly septic patients. However, In the subgroup of moderate metabolic acidosis, SB infusion could be found associated with improved ICU (HR 0.64, 95% CI 0.43–0.95; p <0.05) and hospital (HR 0.70, 95% CI 0.50–0.99; p <0.05) survival in elderly septic patients. In the MSCM, the results were similar with PSA.Conclusion: SB infusion could improve both ICU and hospital survival for elderly septic patients with acute metabolic acidosis. |
| first_indexed | 2024-04-12T04:42:14Z |
| format | Article |
| id | doaj.art-7087f1d9697d4760b532dca5c3eb82cf |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-12T04:42:14Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-7087f1d9697d4760b532dca5c3eb82cf2022-12-22T03:47:36ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-09-011310.3389/fphar.2022.974271974271Effectiveness of sodium bicarbonate infusion on mortality for elderly septic patients with acute metabolic acidosisSai Huang0Sai Huang1Yaojun Peng2Lili Wang3Jing Wang4Xuan Zhou5Xiang Cui6Li Chen7Bo Yang8Cong Feng9Cong Feng10Cong Feng11Cong Feng12Department of Hematology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, ChinaNational Clinical Research Center of Geriatric Diseases, Chinese PLA General Hospital, Beijing, ChinaDepartment of Emergency, First Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of General Medicine, First Medical Center of General Hospital of People’s Liberation Army, Beijing, ChinaDepartment of General Medicine, First Medical Center of General Hospital of People’s Liberation Army, Beijing, ChinaDepartment of Emergency, Hainan Hospital of Chinese PLA General Hospital, Sanya, ChinaDepartment of Orthopedics, Fourth Medical Center, General Hospital of People’s Liberation Army, Beijing, ChinaDepartment of General Medicine, First Medical Center of General Hospital of People’s Liberation Army, Beijing, ChinaDepartment of Thoracic Surgery, First Medical Center, General Hospital of PLA, Beijing, ChinaNational Clinical Research Center of Geriatric Diseases, Chinese PLA General Hospital, Beijing, ChinaDepartment of Emergency, First Medical Center of Chinese PLA General Hospital, Beijing, ChinaState Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, General Hospital of People’s Liberation Army, Beijing, ChinaDepartment of General Medicine, Hainan Hospital of Chinese PLA General Hospital, Sanya, ChinaObjective: This study aimed to explore the effectiveness of sodium bicarbonate (SB) infusion on mortality in elderly septic patients with acute metabolic acidosis (MA) and in other subgroups.Methods: Retrospective analysis of a large ICU database (MIMIC-IV) was performed. Elderly septic patients with acute MA were identified from MIMIC-IV. Propensity score analysis (PSA) was performed to explain for the baseline differences in the probability to receive SB or not. The marginal structural Cox model (MSCM) was developed to adjust for both baseline and time-varying confounding variables. The primary outcome was the ICU and hospital mortality.Results: A total of 869 elderly septic patients with acute MA were identified in this study, including 361 in the SB group and 508 in the non-SB group. In the PSA, SB infusion was not associated with reduced ICU (HR 0.82, 95% CI 0.62–1.10; p = 0.19) or hospital (HR 0.94, 95% CI 0.74–1.19; p = 0.60) mortality in overall elderly septic patients with acute MA. In the subgroup of severe metabolic acidosis, SB infusion could not improve the ICU (HR 0.82, 95% CI 0.62–1.10; p =0.19) and hospital (HR 0.94, 95% CI 0.74–1.19; p =0.60) mortality on elderly septic patients. However, In the subgroup of moderate metabolic acidosis, SB infusion could be found associated with improved ICU (HR 0.64, 95% CI 0.43–0.95; p <0.05) and hospital (HR 0.70, 95% CI 0.50–0.99; p <0.05) survival in elderly septic patients. In the MSCM, the results were similar with PSA.Conclusion: SB infusion could improve both ICU and hospital survival for elderly septic patients with acute metabolic acidosis.https://www.frontiersin.org/articles/10.3389/fphar.2022.974271/fullearly sodium bicarbonate infusionold patientsepsismortalityacute metabolic acidosis |
| spellingShingle | Sai Huang Sai Huang Yaojun Peng Lili Wang Jing Wang Xuan Zhou Xiang Cui Li Chen Bo Yang Cong Feng Cong Feng Cong Feng Cong Feng Effectiveness of sodium bicarbonate infusion on mortality for elderly septic patients with acute metabolic acidosis Frontiers in Pharmacology early sodium bicarbonate infusion old patient sepsis mortality acute metabolic acidosis |
| title | Effectiveness of sodium bicarbonate infusion on mortality for elderly septic patients with acute metabolic acidosis |
| title_full | Effectiveness of sodium bicarbonate infusion on mortality for elderly septic patients with acute metabolic acidosis |
| title_fullStr | Effectiveness of sodium bicarbonate infusion on mortality for elderly septic patients with acute metabolic acidosis |
| title_full_unstemmed | Effectiveness of sodium bicarbonate infusion on mortality for elderly septic patients with acute metabolic acidosis |
| title_short | Effectiveness of sodium bicarbonate infusion on mortality for elderly septic patients with acute metabolic acidosis |
| title_sort | effectiveness of sodium bicarbonate infusion on mortality for elderly septic patients with acute metabolic acidosis |
| topic | early sodium bicarbonate infusion old patient sepsis mortality acute metabolic acidosis |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.974271/full |
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