Predictive Value of Arterial Blood Lactic Acid Concentration on the Risk of in-Hospital All-Cause Death in Patients with Acute Heart Failure

Figure 4

The association between NT-proBNP, lactic acid, and the risk of in-hospital all-cause death. (a) Correlation matrix of NT-proBNP, lactic acid, and the risk of in-hospital all-cause death. (b) Restricted cubic spline plots of associations between NT-proBNP levels and in-hospital all-cause mortality. Note: Analyses were adjusted for age, ethnicity, body mass index, weight, systolic blood pressure, the history of atrial fibrillation, liver cirrhosis, acute myocardial infarction, chronic kidney disease, respiratory failure, chronic obstructive pulmonary disease, ventricular fibrillation, diabetes mellitus, septicaemia, anion gap, bicarbonate, blood urea nitrogen, calcium, serum creatinine, glucose, hematocrit, hemoglobin, platelet, red blood cells, C reactive protein, length of stay, albumin, white blood cells, lactic acid, cardiotonic drugs, nitroglycerin drugs, furosemide drugs, infection-fighting drugs, Simplified Acute Physiology Score II, and sequential organ failure assessment. The solid line and dashed line represent the log-transformed odds ratios and corresponding 95% confidence intervals. (c) Mediation analysis of NT-proBNP on the interaction between lactic acid levels and in-hospital all-cause death. Notes: Mediation models of NT-proBNP, lactic acid, and in-hospital all-cause death in data: direct effect (TE = 0.029307; P < 0.001) of lactic acid (exposure) toward in-hospital all-cause death (outcome), and NT-proBNP medication proportion is 5.9%; indirect effect (IE = 0.001132; P < 0.001) of lactic acid (exposure) toward NT-proBNP (mediator) and effect obesity (DE = 0.028176; P < 0.001), from NT-proBNP (mediator) toward in-hospital all-cause death (outcome).

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