Admission Serum Bicarbonate Predicts Adverse Clinical Outcomes in Hospitalized Cirrhotic Patients

• Published in: Canadian journal of gastroenterology & hepatology 2021, Vol.2021, p.1-8
• Main Authors: Schopis, Michael, Kumar, Anand, Parides, Michael, Tepler, Adam, Sigal, Samuel
• Format: Article
• Language: English
• Subjects: Acidosis; Acute coronary syndromes; Age; Alkalosis; Carbon dioxide; Chronic illnesses; Chronic obstructive pulmonary disease; Creatinine; Diabetes; Heart failure; Hepatitis; Hospitalization; Hospitals; Kidney diseases; Liver cirrhosis; Liver diseases; Mortality; Patients; Phosphatase; Transplants & implants; Variance analysis
• ISSN: 2291-2789; 2291-2797
• DOI: 10.1155/2021/9915055

A low serum bicarbonate (SB) level is predictive of adverse outcomes in kidney injury, infection, and aging. Because the liver plays an important role in acid-base homeostasis and lactic acid metabolism, we speculated that such a relationship would exist for patients with cirrhosis. To assess the prognostic value of admission SB on adverse hospital outcomes, clinical characteristics were extracted and analyzed from a large electronic health record system. Patients were categorized based on admission SB (mEq/L) into 7 groups based on the reference range (22–25) into mildly (18–21), moderately (14–17), and severely (30) increased groups, and the relationship of SB category with the frequency of complications (acute kidney injury/hepatorenal syndrome, portosystemic encephalopathy, gastrointestinal bleeding, ascites, and spontaneous bacterial peritonitis) and hospital metrics (length of stay [LOS], admission to an intensive care unit [ICU], and mortality) was assessed. A total of 2,693 patients were analyzed. Mean SB was 22.9 ± 4.5 mEq/L. SB was within the normal range (22–25 mEq/L) in 1,072 (39.8%) patients, and 955 patients (36%) had a low SB. As the SB category decreased, the incidence of complications progressively increased (p