Dokument: Acidemia predicts mortality independently of lactate levels in patients after cardiac arrest
| Titel: | Acidemia predicts mortality independently of lactate levels in patients after cardiac arrest | |||||||
| URL für Lesezeichen: | https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=72329 | |||||||
| URN (NBN): | urn:nbn:de:hbz:061-20260218-114115-1 | |||||||
| Kollektion: | Publikationen | |||||||
| Sprache: | Englisch | |||||||
| Dokumententyp: | Wissenschaftliche Texte » Artikel, Aufsatz | |||||||
| Medientyp: | Text | |||||||
| Autoren: | Duse, Dragos A. [Autor] Ganea, Andreea I. [Autor] Horn, Patrick [Autor] Ortkemper, Matthias [Autor] Haschemi, Jafer [Autor] Deffke, Philipp [Autor] Jung, Christian [Autor] Kelm, Malte [Autor] Erkens, Ralf [Autor] | |||||||
| Dateien: |
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| Stichwörter: | Lactate , Mortality , pH , Cardiac arrest , Neurological outcome | |||||||
| Beschreibung: | Aim
We examined whether post-cardiac arrest acidemia is associated with 30-day mortality and neurological outcomes among hospital survivors, independent of lactate and partial arterial carbon dioxide pressure (paCO2) levels, in patients after cardiopulmonary resuscitation (CPR). Methods The predictive value of acidemia for in-hospital mortality was analyzed retrospectively in 742 non-traumatic cardiac arrest patients admitted to a German high-volume tertiary center using receiver operating characteristic (ROC) analysis. Patients were stratified using the ROC-derived (Youden-optimal) pH cut-off, and 30-day mortality was compared across strata. Cox regression assessed the association between severe acidemia (pH ≤ 7.2, binary) and mortality and examined its consistency across prespecified subgroups (age, sex, cardiac arrest type, lactate, and paCO2). Preliminary findings were externally validated in a database containing over 2000 patients from multiple intensive care units (eICU database). Results Admission pH levels predicted in-hospital mortality (area-under-curve 0.75, p < 0.0001). The ROC-derived Youden-optimal threshold was pH 7.207; for clinical interpretability, this value was rounded to pH 7.2 and used as the cut-off for severe acidemia. Patients with severe acidemia exhibited substantially higher in-hospital and 30-day mortality. Among hospital survivors, no statistically significant association between admission pH and neurological outcome was observed. In Cox models, pH ≤ 7.20 remained significantly associated with mortality independent of lactate, paCO2, arrest type, age, and sex. In the validation eICU cohort, pH ≤ 7.2 accurately stratified cardiac-arrest patients with a higher mortality risk. This association persisted in Cox regression analyses of subgroups stratified by lactate and paCO2 levels (all p < 0.0001), as proxies for systemic hypoperfusion and ventilation. Conclusion Post-cardiac-arrest acidemia is associated with higher mortality independently of lactate, ventilation, or CPR characteristics. Among hospital survivors, admission pH was not significantly associated with neurological outcome. These findings support pH as an early marker for mortality risk stratification after cardiac arrest, to be interpreted in the context of multimodal prognostication. | |||||||
| Rechtliche Vermerke: | Originalveröffentlichung:
Duşe, D. A., Ganea, A. I., Horn, P., Ortkemper, M., Haschemi, J., Deffke, P., Jung, C., Kelm, M., & Erkens, R. (2026). Acidemia predicts mortality independently of lactate levels in patients after cardiac arrest. Resuscitation Plus , 28, Article 101234. https://doi.org/10.1016/j.resplu.2026.101234 | |||||||
| Lizenz: |  Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz | |||||||
| Fachbereich / Einrichtung: | Medizinische Fakultät | |||||||
| Dokument erstellt am: | 18.02.2026 | |||||||
| Dateien geändert am: | 18.02.2026 |
