ArticleBMC anesthesiology2024
Association between baseline serum bicarbonate and the risk of postoperative delirium in patients undergoing cardiac surgery in the ICU: a retrospective study from the MIMIC-IV database.
Article in BMC anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Electrolyte trajectory-based subphenotypes and their association with hospital length of stay in prostate cancer patients.Translational andrology and urology · 2026Article
- Dynamic BUN patterns in the ICU: risk stratification and prognosis following cardiac surgery.Journal of cardiothoracic surgery · 2026Article
- Association Between Serum Anion Gap and Risk of Postoperative Delirium in Patients Undergoing Gastric Surgery in ICU: A Retrospective Study From the MIMIC-IV Database.Anesthesiology research and practice · 2026Article
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7 authors.
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Abstract
backgroundAlthough serum bicarbonate is a reliable predictor of various disease complications, its relationship with postoperative delirium (POD) remains unclear. Our research aimed to assess the effect of baseline serum bicarbonate levels on the incidence of POD in cardiac surgery patients.
methodsA retrospective analysis was conducted on cardiac surgery patients who met specific inclusion and exclusion criteria, using data from the Marketplace for Information in Critical Care Medicine (MIMIC-IV) database. Univariate and multivariate logistic regression models are employed to explore the correlation between serum bicarbonate levels and the risk of POD, and their predictive efficacy is assessed by means of restricted cubic spline regression models (RCS) and receiver operating characteristic curves (ROC). In addition, subgroup and sensitivity analyses are conducted to test the robustness of the results.
resultsIn this study, 5,422 patients were included, where the incidence of POD was 13.0%. For each 1 mmol/L increase in bicarbonate, a 13% reduction in the risk of POD was observed in the fully adjusted model (OR = 0.87, 95% CI: 0.83-0.91, P < 0.001). The RCS model demonstrated a linear negative correlation between the level of bicarbonate and the risk of POD (P for nonlinearity = 0.987). The ROC curve analysis demonstrated that the bicarbonate level had moderate predictive efficacy (AUC = 0.629). Both subgroup and sensitivity analyses reaffirmed the robustness of these results.
conclusionsLower baseline serum bicarbonate levels in cardiac surgery patients are linked to a higher risk of POD. Monitoring and adjusting serum bicarbonate levels may help identify high-risk patients and potentially improve outcomes.
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