Prognostic value of admission base excess in postoperative outcomes of aortic dissection patients: a retrospective cohort analysis.

Purpose: The aim of this retrospective study was to evaluate the relationship between admission base excess and clinical outcomes in postoperative patients with aortic dissection. Methods: Clinical data were extracted from the MIMIC-IV (Medical Information Mart for Intensive Care IV) database. The association between admission base excess and mortality in postoperative patients with aortic dissection was assessed using multivariate Cox regression and Kaplan-Meier survival analysis. Subgroup analysis and receiver operating characteristic (ROC) curve analysis were employed to evaluate the predictive performance of base excess for in-hospital, 30-day, 90-day, and 1-year mortality. Results: A total of 196 patients were categorized into the normal base excess (-3 to +3 mmol/L) group and abnormal base excess (<-3 or >+3 mmol/L) group. Multivariate Cox regression analysis revealed that arterial base excess was a significant predictor of all-cause mortality across all periods. Subgroup analyses showed no significant interaction effects. The area under the ROC curve for base excess ranged from 0.640 to 0.745, indicating comparable predictive performance to existing scoring tools. Conclusion: Arterial base excess measured at admission is an effective and accessible predictor of mortality in patients with aortic dissection following surgical treatment.