{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T12:18:41Z","timestamp":1783167521769,"version":"3.54.6"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acid\u2013base disturbances are common in critically ill patients and provide immediate physiological insight and prognostic information. We aimed to characterize the epidemiology of specific acid\u2013base patterns and to develop ABG-driven models for 28-day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 1150 critically ill adults with acid\u2013base disorders identified from the first arterial blood gas (ABG) after ICU admission. The primary outcome was 28-day mortality. Three multivariable logistic regression models were developed: (1) a continuous model using physiological variables, (2) a pragmatic threshold-based model with Firth bias-reduced logistic regression, and (3) an ABG-only model. Discrimination (area under the receiver operating characteristic curve [AUC]), calibration, Brier score, and decision curve analysis (DCA) were reported with bootstrap optimism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mixed acid\u2013base disorders were the most prevalent (35.7%) and associated with high mortality (73.2%), while respiratory alkalosis also carried high mortality (69.6%). Non-survivors showed an apparently \u201cnormal\u201d or higher pH (7.40 vs 7.30) despite marked hypocapnia and elevated lactate (4.8 vs 2.5\u2005mmol\/L). The continuous model achieved an AUC of 0.94 (optimism-corrected 0.88). The threshold model achieved an AUC of 0.85, with lactate &gt; 4\u2005mmol\/L (adjusted odds ratio [aOR] 7.68) and sepsis (aOR 2.78) as dominant predictors. The ABG-only model maintained high discrimination (AUC 0.92; optimism-corrected 0.88) with acceptable calibration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Routine ABG combined with basic clinical data at ICU admission enables accurate early mortality risk stratification in ICU patients. An apparently normal pH may conceal severe metabolic stress, emphasizing the need for integrated acid\u2013base assessment in critical care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666261442193","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T05:18:13Z","timestamp":1782883093000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Arterial Blood Gas\u2013Derived Risk Models for 28-Day Mortality in Critically Ill Adults: A Retrospective Cohort Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3443-6390","authenticated-orcid":false,"given":"Hesham Kamal Habeeb","family":"Keryakos","sequence":"first","affiliation":[{"name":"Minia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0677-7139","authenticated-orcid":false,"given":"Sohair Adeeb","family":"Megalla","sequence":"additional","affiliation":[{"name":"Minia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3822-8824","authenticated-orcid":false,"given":"Shaimaa Hassaan Hamdy","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Minia University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.04500422"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc3796"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc10487"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1441-2772(23)02175-0"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2023.154381"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.024932"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2012.186"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2013.06.012"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X06295361"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31819fcf68"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.65.5654"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-024-07656-5"},{"issue":"5","key":"e_1_3_4_14_2","first-page":"713","article-title":"Serum proteins and acid-base equilibria: A follow-up","volume":"120","author":"Figge J","year":"1992","unstructured":"Figge J, Mydosh T, Fencl V. Serum proteins and acid-base equilibria: A follow-up. J Lab Clin Med. 1992;120(5):713-719.","journal-title":"J Lab Clin Med"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06506-y"}],"container-title":["Journal of Intensive Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08850666261442193","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08850666261442193","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08850666261442193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T11:48:16Z","timestamp":1783165696000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08850666261442193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":14,"alternative-id":["10.1177\/08850666261442193"],"URL":"https:\/\/doi.org\/10.1177\/08850666261442193","relation":{},"ISSN":["0885-0666","1525-1489"],"issn-type":[{"value":"0885-0666","type":"print"},{"value":"1525-1489","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"article-number":"08850666261442193"}}