The following is a summary of “Prognosis of patients with extreme acidosis on admission to the emergency department: A retrospective cohort study,” published in the February 2024 issue of Emergency Medicine by Gutgold, et al.

For a study, researchers sought to assess the prognosis of patients presenting to the emergency department with a pH lower than 6.9, considering the significance of extreme acidosis in critically ill patients.

The retrospective cohort study examined adult patients admitted to two emergency departments within 12 hours of admission with a pH < 6.9. The primary outcome measure was mortality within 24 hours of emergency department admission. A regression analysis of clinical and laboratory data was conducted to identify factors associated with mortality in the patient population.

Data from 206 emergency department admissions between 2008 and 2018 with extreme acidosis were analyzed. pH values ranged from 6.898 to 6.35 (mean 6.8, median 6.83). Of these admissions, 60 patients (29%) survived the first 24 hours. Among the survivors, 35 patients (58%) also survived hospital discharge, with 80% of them returning to their previous functional status. Patient age, type of acidosis, cardio-pulmonary resuscitation on arrival, and diagnosis at admission were correlated with survival outcomes.

A noteworthy proportion of patients presenting with extreme acidosis in the emergency department survived at least 24 hours until hospital discharge. The findings suggested that clinical decision-making should consider additional prognostic factors beyond pH value alone.

Reference: sciencedirect.com/science/article/abs/pii/S073567572300606X