The Prognosis Prediction in Non-Traumatic Hemorrhagic Stroke with Base Excess Levels in the Emergency Department

Background The base excess (BE) parameter reflects the body’s acid-base imbalance and compensatory capacity. It can predict the prognosis of various clinical conditions in the emergency department (ED). This study aims to evaluate the prognostic value of BE in patients admitted to the ED with non-traumatic hemorrhage. Methods This study involved 453 adult patients with non-traumatic hemorrhage who presented to our ED. We recorded data on demographics, gender, comorbidities, Glasgow Coma Scale (GCS) scores, history of antiaggregant and anticoagulant use, type of hemorrhage, arterial blood gas (ABG) values, 30-day mortality rates, length of hospitalization, and surgical requirements. Results The mean age of the study group was 64.99 ± 15.18 years, with a range of 20 to 99 years. Among patients who survived for 30 days, the mean BE level was + 2.88 ± 4.47 mEq/L. In contrast, the mean BE level was + 0.09 ± 4.97 mEq/L among those who did not survive beyond 30 days. There was a statistically significant relationship between BE categories and 30-day survival (p < 0.001). Furthermore, BE level was significantly associated with both discharge and death outcomes (p < 0.001). ROC analysis for BE and 30-day mortality yielded an area under the curve (AUC) of 0.688 (p < 0.001). For the relationship between lactate level and 30-day mortality, the ROC analysis showed an AUC of 0.654. Conclusion Our study demonstrated that admission BE levels could be a significant predictor of 30-day mortality in patients diagnosed with non-traumatic hemorrhage, compared to lactate levels.