The following is a summary of ”Association of standard base excess upon emergency admission with outcomes in patients with heat stroke,” published in the October 2023  issue of Emergency Medicine by Chen, et al.

Standard base excess (SBE) is a quick and accurate way to find acid-base problems in critically sick patients unaffected by breathing factors. It still needs to be clarified how well SBE can predict bad results for people with heat stroke (HS). The point of this study was to find out what role SBE plays in predicting death in the hospital and other bad results for people with HS. A joint retrospective observational group study was done with patients seen at the same center every year from 2021 to 2022. The SBE was done when the patient was taken to the emergency room (ED). 

The main result was death in the hospital. The use of vasoactive drugs in the emergency room, transfer to the intensive care unit, acute kidney failure, acute heart failure, acute lung failure, sepsis, and problems with blood clotting were some of the secondary events. Researchers used receiver operating characteristic (ROC) curves and logistic regression models to determine how SBE was linked to results in HS cases. There were also interaction and subgroup studies. Between -8.05 and -1.55 mmol/L, the middle level of SBE was -4.70 mmol/L. The overall death rate for these 151 HS patients in the hospital was 12.58%. SBE was linked to hospital death on its own (OR 0.81, 95% CI 0.70–0.95, P = 0.011). 

The link between SBE and in-hospital death was complex, involving both age and HS type. Or between SBE and hospital death was 0.5 (95% CI, 0.3–0.9; p < 0.018) for people in the traditional HS group and 0.62 (95% CI, 0.45–0.87; p = 0.005) for people over 65. The AUC of SBE to predict death in the hospital was 0.868 (95% CI: 0.704–0.962) for the first group and 0.883 (95% CI: 0.750–0.951) for the second. There was a strong link between SBE and being admitted to the intensive care unit, having acute kidney failure, acute lung failure, sepsis, and problems with blood clotting. SBE at the time of emergency entry was strongly linked to bad results in patients with HS.

Source: sciencedirect.com/science/article/pii/S0735675723003443