ArticlePloS one2018
Base excess is superior to lactate-levels in prediction of ICU mortality after cardiac surgery.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Prognostic Value of Standard Base Excess in Sepsis-Associated Acute Kidney Injury: A Retrospective Cohort Study.International journal of nephrology · 2026Article
- Association between standard base excess and acute kidney injury in intensive care unit patients: a study based on the medical information mart for intensive care database.BMC nephrology · 2025Article
- Prognostic value of admission base excess in postoperative outcomes of aortic dissection patients: a retrospective cohort analysis.Annals of surgical treatment and research · 2025Article
- The relationship between blood glucose and clinical outcomes after extracorporeal circulation: a retrospective cohort study.Frontiers in cardiovascular medicine · 2025Article
- Early Mortality in Cardiac Surgery - Is Lactate Significant?Brazilian journal of cardiovascular surgery · 2024Article
- Association Between the Red Blood Cell Distribution Width and 30-Day Mortality in Intensive Care Patients Undergoing Cardiac Surgery: A Retrospective Observational Study Based on the Medical Information Mart for Intensive Care-IV Database.Annals of laboratory medicine · 2024Observational
- Association between lactic acidosis and multiple organ dysfunction syndrome after cardiopulmonary bypass.PeerJ · 2024Article
- Factors associated with increased lactate levels in cardiac surgeries: scoping review.Revista brasileira de enfermagem · 2024Article
- Preoperative Base Excess as a Predictor of Perioperative Complications in Patients with Nonidiopathic Scoliosis who Have High Risk Associated with General Anesthesia.Spine surgery and related research · 2023Article
- Association between base excess and 28-day mortality in sepsis patients: A secondary analysis based on the MIMIC- IV database.Heliyon · 2023Article
- Admission Lactate Concentration, Base Excess, and Alactic Base Excess Predict the 28-Day Inward Mortality in Shock Patients.Journal of clinical medicine · 2022Article
- Rates and Determinants of Hospital-Acquired Infection among ICU Patients Undergoing Cardiac Surgery in Developing Countries: Results from EMERGENCY'NGO's Hospital in Sudan.Antibiotics (Basel, Switzerland) · 2022Article
- DeepBiomarker: Identifying Important Lab Tests from Electronic Medical Records for the Prediction of Suicide-Related Events among PTSD Patients.Journal of personalized medicine · 2022Article
- Acute Kidney Injury in Cardiogenic Shock: An Updated Narrative Review.Journal of cardiovascular development and disease · 2021Review
- Prognostic dynamic nomogram integrated with metabolic acidosis for in-hospital mortality and organ malperfusion in acute type B aortic dissection patients undergoing thoracic endovascular aortic repair.BMC cardiovascular disorders · 2021Article
- Association between base excess and mortality in patients with congestive heart failure.ESC heart failure · 2021Article
- Course of lactate, pH and base excess for prediction of mortality in medical intensive care patients.PloS one · 2021Article
- ΔPCOFrontiers in cardiovascular medicine · 2021Article
- Article
- Prolonged use of noninvasive positive pressure ventilation after extubation among patients in the intensive care unit following cardiac surgery: The predictors and its impact on patient outcome.Scientific reports · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCardiac surgery with the use of cardiopulmonary bypass is known to induce distinct metabolic changes. Respective changes in acid-base status including increased systemic lactate levels were previously related to clinical outcomes, but data remain controversial. Therefore, we aim to investigate the relevance of lactate and base excess (BE) levels on ICU-mortality in patients admitted to the ICU after cardiac surgery. MATERIALS AND
methodsPerioperative data of patients treated in a tertiary care academic center admitted to the ICU after on-pump surgery were analyzed in a retrospective fashion. Receiver operation characteristic (ROC) curves were constructed for admission lactate-levels and BE with calculation of optimal cut-off values to predict ICU mortality. Univariate followed by multivariate regression models were constructed to identify potential outcome-relevant indices.
resultsData from 1,058 patients were included in the analysis. Area under the curves for prediction of ICU mortality were 0.79 for lactate levels at ICU admission (sensitivity 61.9%/ specificity 87.5%; optimal cut-off level 3.9mmol/l), and 0.7 for BE (sensitivity 52.4%/ specificity 93.8%, optimal cut-off level -6.7), respectively. Multivariate regression identified BE < -6.7 as the single metabolic predictor of ICU-mortality (HR 4.78, 95%-CI 1.4-16.33, p = 0.01). Explorative subgroup analyses revealed that the combination of lactate ≤3.9mmol/l and BE ≤ -6.7 has stronger impact on mortality than a combination of lactate of >3.9mmol/l and BE > -6.7 (HR 2.56, 95%-CI 0.18-37.17).
conclusionsAt ICU-admission, severely reduced BE appears superior to hyperlactatemia with regard to prediction of ICU-mortality in patients after cardiac surgery.
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