Association Between the Use of Sodium Bicarbonate and Mortality in Acute Kidney Injury Using Marginal Structural Cox Model

This study assessed the associations between the use of IV sodium bicarbonate and mortality of patients with acute kidney injury and acidosis. Design: The study was conducted by using data from Beth Israel Deaconess Medical Center, which included several ICUs such as coronary care unit, cardiac surgery recovery unit, medical ICU, surgical ICU, and trauma-neuro ICU. Marginal structural Cox model was used to assess the relationship between receipt of sodium bicarbonate and hospital mortality, allowing pH, Paco2, creatinine, and bicarbonate concentration as time-varying predictors of sodium bicarbonate exposure while adjusting for baseline characteristics of age, gender, Sequential Organ Failure Assessment score, acute kidney injury stage, Elixhauser score, quick Sequential Organ Failure Assessment, and Simplified Acute Physiology Score II. Setting: A large U.S.-based critical care database named Medical Information Mart for Intensive Care. Patients: Patients with Kidney Disease: Improving Global Outcomes acute kidney injury stage greater than or equal to 1 (> 1.5 JOURNAL/ccme/04.03/00003246-201910000-00016/inline-graphic1/v/2019-09-16T181613Z/r/image-tiff baseline creatinine) and one measurement of acidosis (pH ≤ 7.2). Baseline creatinine was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation. Interventions: None. Measurements and Main Results: Of the 3,406 eligible patients, 836 (24.5%) had received sodium bicarbonate treatment. Pat...
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Clinical Investigations Source Type: research