<strong>Background:</strong> <span style="font-size:12px;font-family:Verdana;">Metabolic acidosis (MA) is a common finding on the surgical ward, more so in the intensive care unit. Diseases...<strong>Background:</strong> <span style="font-size:12px;font-family:Verdana;">Metabolic acidosis (MA) is a common finding on the surgical ward, more so in the intensive care unit. Diseases affecting the major organ systems of the body and higher grades of surgery are common risk factors for MA. It is associated with poor treatment outcome. </span><b><span style="font-size:12px;font-family:Verdana;">Aim</span></b><b><span style="font-size:12px;font-family:Verdana;">:</span></b><b><span style="font-size:10.0pt;font-family:;" "=""> </span></b><span style="font-size:12px;font-family:Verdana;">To determine the risk factors and clinical correlates of metabolic acidosis and assess its relationship with treatment outcome. </span><b><span style="font-size:12px;font-family:Verdana;">Methodology:</span></b><span style="font-size:12px;font-family:Verdana;"> A retrospective study at the “Tristate Heart and vascular Center” in Ilishan-Remo South west Nigeria, on patients that had cardiac and vascular surgeries </span><span style="font-size:12px;font-family:Verdana;">from</span><span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;font-size:12px;"> January 2015 to De</span><span style="font-family:Verdana;font-size:12px;">cember 2019. Three hundred and forty two participants took part in the </span><span style="font-family:Verdana;font-size:12px;">study. The demographic, clinical and laboratory findings were entered. Statistical analysis was with Student’s t-test and Chi square. </span></span><b><span style="font-size:12px;font-family:Verdana;">Results:</span></b><span style="font-size:12px;font-family:Verdana;"> Two hundred and six males and 136 females were studied. The incidence</span><span style="font-size:12px;font-family:Verdana;">s</span><span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;font-size:12px;"> of metabolic acidosis prior to induction, on post-operative day one (POD</span><sup><span style="font-family:Verdana;font-size:12px;">1</span></sup><span style="font-family:Verdana;font-size:12px;">) and on POD</span><sup><span style="font-family:Verdana;font-size:12px;">28</span></sup> <span style="font-family:Verdana;font-size:12px;">were 20.7%, 39.8% and 14.1%</span></span><span style="font-size:12px;font-family:Verdana;"> respectively</span><span style="font-size:12px;font-family:Verdana;">. Nine (2.6%) participants died</span><span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;font-size:12px;"> during admission, of this, 6 (66.7%) had MA at presentation but all (100%) had MA on POD</span><sup><span style="font-family:Verdana;font-size:12px;">1</span></sup><span style="font-family:Verdana;font-size:12px;">. The Risk factors for MA were advanced age, comorbidities, open heart surgery, elevated systolic blood pressure and low eGFR. Metabolic acidosis was a risk factor for prolonged hospital stay, perioperative death and declining kidney function which was commoner among participants with preexisting kidney dysfunction.</span></span><b><span style="font-size:12px;font-family:Verdana;"> Conclusion: </span></b><span><span>The incidence of metabolic acidosis was 20.7% at induction of anesthesia, rose to 39.8% on POD</span><sup><span>1</span></sup><span> and by POD</span><sup><span>28</span></sup><span>, it has significantly reduced to 14.1%. While advancing age and comorbidities were risk factors for MA, the occurrence of MA increased the risk of declining kidney function, prolonged hospital stay and death.</span></span>展开更多
文摘<strong>Background:</strong> <span style="font-size:12px;font-family:Verdana;">Metabolic acidosis (MA) is a common finding on the surgical ward, more so in the intensive care unit. Diseases affecting the major organ systems of the body and higher grades of surgery are common risk factors for MA. It is associated with poor treatment outcome. </span><b><span style="font-size:12px;font-family:Verdana;">Aim</span></b><b><span style="font-size:12px;font-family:Verdana;">:</span></b><b><span style="font-size:10.0pt;font-family:;" "=""> </span></b><span style="font-size:12px;font-family:Verdana;">To determine the risk factors and clinical correlates of metabolic acidosis and assess its relationship with treatment outcome. </span><b><span style="font-size:12px;font-family:Verdana;">Methodology:</span></b><span style="font-size:12px;font-family:Verdana;"> A retrospective study at the “Tristate Heart and vascular Center” in Ilishan-Remo South west Nigeria, on patients that had cardiac and vascular surgeries </span><span style="font-size:12px;font-family:Verdana;">from</span><span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;font-size:12px;"> January 2015 to De</span><span style="font-family:Verdana;font-size:12px;">cember 2019. Three hundred and forty two participants took part in the </span><span style="font-family:Verdana;font-size:12px;">study. The demographic, clinical and laboratory findings were entered. Statistical analysis was with Student’s t-test and Chi square. </span></span><b><span style="font-size:12px;font-family:Verdana;">Results:</span></b><span style="font-size:12px;font-family:Verdana;"> Two hundred and six males and 136 females were studied. The incidence</span><span style="font-size:12px;font-family:Verdana;">s</span><span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;font-size:12px;"> of metabolic acidosis prior to induction, on post-operative day one (POD</span><sup><span style="font-family:Verdana;font-size:12px;">1</span></sup><span style="font-family:Verdana;font-size:12px;">) and on POD</span><sup><span style="font-family:Verdana;font-size:12px;">28</span></sup> <span style="font-family:Verdana;font-size:12px;">were 20.7%, 39.8% and 14.1%</span></span><span style="font-size:12px;font-family:Verdana;"> respectively</span><span style="font-size:12px;font-family:Verdana;">. Nine (2.6%) participants died</span><span style="font-size:10.0pt;font-family:;" "=""><span style="font-family:Verdana;font-size:12px;"> during admission, of this, 6 (66.7%) had MA at presentation but all (100%) had MA on POD</span><sup><span style="font-family:Verdana;font-size:12px;">1</span></sup><span style="font-family:Verdana;font-size:12px;">. The Risk factors for MA were advanced age, comorbidities, open heart surgery, elevated systolic blood pressure and low eGFR. Metabolic acidosis was a risk factor for prolonged hospital stay, perioperative death and declining kidney function which was commoner among participants with preexisting kidney dysfunction.</span></span><b><span style="font-size:12px;font-family:Verdana;"> Conclusion: </span></b><span><span>The incidence of metabolic acidosis was 20.7% at induction of anesthesia, rose to 39.8% on POD</span><sup><span>1</span></sup><span> and by POD</span><sup><span>28</span></sup><span>, it has significantly reduced to 14.1%. While advancing age and comorbidities were risk factors for MA, the occurrence of MA increased the risk of declining kidney function, prolonged hospital stay and death.</span></span>
