Prognostic value of early point-of-care blood gas analysis in critically ill non-trauma patients.
- 1Department of Emergency Medicine, University Hospital Regensburg, Regensburg, Germany. [email protected].
- 2Department of Emergency Medicine, University Hospital Regensburg, Regensburg, Germany.
- 3Department for Infection Control and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany.
Abstract
Background
Critically ill non-trauma patients treated in the emergency department have a high risk of in-hospital mortality. While point-of-care diagnostics such as blood gas analysis are established tools for urgent management, data on their prognostic value in this specific patient cohort remain limited. This study aimed to evaluate whether initial blood gas parameters are independently associated with in-hospital mortality in critically ill non-trauma patients.Methods
This retrospective cohort study included adult critically ill non-trauma patients treated in the emergency department of a German university hospital. Initial blood gas parameters and clinical data were analyzed using univariate and multivariable logistic regression to assess their association with in-hospital mortality.Results
Of 879 screened patients, 542 met the inclusion criteria. In-hospital mortality was 20% (n = 110). In addition to older age and out-of-hospital cardiac arrest, anemia (hemoglobin < 12 g/dL; OR of 2.07, 95% CI 1.20-3.58; p = 0.009), acidosis (pH < 7.35; OR 2.26, 95% CI 1.09-4.95; p = 0.033) and hypobicarbonatemia (< 22 mmol/L; OR 2.79, 95% CI 1.42-5.69; p = 0.004) were independently associated with in-hospital mortality. The association for hyperlactatemia was borderline (> 2.2 mmol/L; OR 1.85, 95% CI 0.93-3.77; p = 0.08). Multivariate analysis did not reveal significant associations between other electrolyte imbalances and in-hospital mortality in this cohort.Conclusion
In this retrospective cohort, the presence of anemia, acidosis or hypobicarbonatemia on admission to the resuscitation room were independently associated with an elevated risk of in-hospital mortality in critically ill non-trauma patients. These readily available point-of-care parameters may support early risk stratification. Prospective studies are needed to validate these findings.
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BibTeX
@article{maierstocker2026prognostic,
title = {{Prognostic value of early point-of-care blood gas analysis in critically ill non-trauma patients.}},
author = {Constantin Maier-Stocker and Rebekka Läng and Jillena Zinsser-Krys and Frank Hanses and Markus Zimmermann and Julian Hupf},
journal = {BMC emergency medicine},
year = {2026},
month = oct,
doi = {10.1186/s12873-026-01822-2},
url = {https://europepmc.org/article/MED/42907747},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prognostic value of early point-of-care blood gas analysis in critically ill non-trauma patients.
AU - Constantin Maier-Stocker
AU - Rebekka Läng
AU - Jillena Zinsser-Krys
AU - Frank Hanses
AU - Markus Zimmermann
AU - Julian Hupf
PY - 2026
DA - 2026/10/21
JO - BMC emergency medicine
DO - 10.1186/s12873-026-01822-2
UR - https://europepmc.org/article/MED/42907747
AB - Background Critically ill non-trauma patients treated in the emergency department have a high risk of in-hospital mortality. While point-of-care diagnostics such as blood gas analysis are established tools for urgent management, data on their prognostic value in this specific patient cohort remain limited. This study aimed to evaluate whether initial blood gas parameters are independently associated with in-hospital mortality in critically ill non-trauma patients.Methods This retrospective cohort study included adult critically ill non-trauma patients treated in the emergency department of a German university hospital. Initial blood gas parameters and clinical data were analyzed using univariate and multivariable logistic regression to assess their association with in-hospital mortality.Results Of 879 screened patients, 542 met the inclusion criteria. In-hospital mortality was 20% (n = 110). In addition to older age and out-of-hospital cardiac arrest, anemia (hemoglobin < 12 g/dL; OR of 2.07, 95% CI 1.20-3.58; p = 0.009), acidosis (pH < 7.35; OR 2.26, 95% CI 1.09-4.95; p = 0.033) and hypobicarbonatemia (< 22 mmol/L; OR 2.79, 95% CI 1.42-5.69; p = 0.004) were independently associated with in-hospital mortality. The association for hyperlactatemia was borderline (> 2.2 mmol/L; OR 1.85, 95% CI 0.93-3.77; p = 0.08). Multivariate analysis did not reveal significant associations between other electrolyte imbalances and in-hospital mortality in this cohort.Conclusion In this retrospective cohort, the presence of anemia, acidosis or hypobicarbonatemia on admission to the resuscitation room were independently associated with an elevated risk of in-hospital mortality in critically ill non-trauma patients. These readily available point-of-care parameters may support early risk stratification. Prospective studies are needed to validate these findings.
SN - 1471-227X
ER -