ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1654432
Acidosis and in-hospital mortality in patients with pulmonary hypertension: a retrospective cohort study based on the MIMIC-IV databaseAssociation with acidosis in patients with pulmonary hypertension: analysis of the MIMIC-IV database
Provisionally accepted
- Suzhou Dushu Lake Hospital, Suzhou, China
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Background: Pulmonary hypertension (PH) is a life-threatening disease. However, acidosis could be used to predict the prognosis of critically ill patients. Consequently, this study was to identify the link between acidosis and in-hospital death of PH patients based on the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Methods: Eligible subjects from the MIMIC-IV database were selected for this analysis (2008-2019), after which differences in variables between the survival statuses of PH patients were evaluated. Subsequently, employing three weighted multiple logistic regression models to investigate the link between acidosis and PH. Further, risk stratification analysis were applied to explore the relationships between acidosis as well as other covariates and PH. Results: Total 2,530 PH patients (247 dead and 2,283 live or 157 acidosis and 2,373 non-acidosis) were included in the analysis. Next, the result indicated highly significant differences between the dead and live groups in factors such as acidosis and sepsis (P < 0.0001). It also showed highly significant differences between the acidosis and non-acidosis groups in factors such as creatinine and sepsis (P < 0.0001). Subsequently, a consistent significant association was found between acidosis and PH, there into, Model 1 displayed an odds ratio (OR) of 5.53 (95% confidence interval (CI): 3.83-7.92, P = 2.71 × 10-20), Model 2 showed an OR of 5.56 (95% CI: 3.83-8.00, P = 6.33 × 10-20), Model 3 reported an OR of 2.19 (95% CI: 1.36-3.51, P = 1 × 10-3), indicating that the impact of acidosis on PH was not significantly affected by other covariates. Notably, risk stratification further revealed acidosis as a risk factor for PH was stable across populations (OR > 1, P < 0.05). Conclusion: This study identified acidosis was a risk factor for PH, highlighting the importance of monitoring in PH patients at risk for acidosis.
Keywords: pulmonary hypertension, Acidosis, Mortality, association analysis, Risk stratification analysis
Received: 26 Jun 2025; Accepted: 25 Aug 2025.
Copyright: © 2025 Ye, Yin, Lin, Sun, Wang and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qiang Guo, Suzhou Dushu Lake Hospital, Suzhou, China
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