Electrolyte affecting in-hospital cause mortality in patients with cardiac arrest within 30 days: a retrospective study based on the MIMIC-IV database

Abstract

Background: Electrolyte imbalance is closely related to the occurrence and prognosis of cardiac arrest. However, current research mainly focuses on the three ions—sodium, potassium, and calcium—while lacking attention to magnesium ions, chloride ions, bicarbonate ions, and phosphate ions. Therefore, we plan to explore the effects of electrolytes on the 30-day in-hospital mortality rate of patients with cardiac arrest based on the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.

Method: Data were collected from the MIMIC IV database version 3.0 (v3.0) on electrolyte levels and 30-day in-hospital mortality rates of hospitalized patients with “cardiac arrest” from 2008 to 2022. Cox regression analysis was used to identify variables that affect the 30-day mortality rate of patients. Finally, the Kaplan-Meier curve was used in this study to further explore the effects of electrolytes on the 30-day mortality rate of patients.

Result: A total of 1491 patients who experienced cardiac arrest were included in this study. Cox regression analysis showed a correlation between age, calcium ions, bicarbonate ions, chloride ions, phosphate, and the 30-day in-hospital mortality rate in patients. The Kaplan-Meier curve further revealed that patients with advanced age, low calcium ion concentration, low chloride ion concentration, low bicarbonate concentration, and high phosphate concentration had poor prognoses.

Conclusion: Levels of bicarbonate ions, chloride ions, and inorganic phosphate at admission were associated with mortality on day 30 of admission.

Keywords

Bicarbonate ions / Cardiac arrest / Chloride ions / MIMIC-IV / Phosphate

Conflict of interest statement

Hongke Zeng is an Editorial Board Member of Emergency Critical Care Medicine. The article was subject to the journal’s standard procedures, with peer review handled independently of this Editorial Board Member and their research groups. The authors declare no conflict of interest.

Author contributions

Tang J participated in data acquisition and revisions of data analysis and interpretation. Zeng H participated in study conception and design, data interpretation, and manuscript revisions, and supervised the whole study. All authors provided their final approval for manuscript submission.

Funding

This work was supported by the Natural Science Foundation of Guangdong Province (A1515012665).

Ethical approval of studies and informed consent

The study follows the principles of the Declaration of Helsinki, as amended in 2013. This study is based on the Critical Care Medical Information Market (MIMIC)-IV Critical Care dataset. It was approved by the institutional review boards at Beth Israel Deaconess Medical Center in Boston, Massachusetts (2001-P-001699/14) and the Massachusetts Institute of Technology (0403000206) for use in research without the need for individual patient informed consent because the data are de-identified and publicly available.

Acknowledgments

We appreciate the excellent work of the MIMIC team (Massachusetts Institute of Technology Laboratory for Computational Physiology) for continuously collecting bedside data and making the database available to all intensive care researchers.

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