Gürbüz MERAL, Serkan GÜNAY, Ramazan ÖZEL, Ahmet KÖSE
Eurasian Journal of Emergency Medicine - 2026;25(1):175-185
Aim: To evaluate whether adding base excess (BE), alone or in combination with lactate, to the modified Rapid Emergency Medicine score (mREMS) improves 30-day mortality prediction in emergency department (ED) red-zone patients. Materials and Methods: This observational cohort study included eligible ED red-zone patients presenting between May 2018 and December 2019 (n=1798). Results: Thirty-day mortality was associated with older age, lower systolic blood pressure, lower SpO2, and lower GCS (p<0.05). BE was not predictive when modeled as a continuous variable; however, it demonstrated an independent association with mortality when modeled as an ordinal variable (p=0.022). The AUC of the baseline mREMS was 0.753; it increased to 0.767 with the addition of BE and to 0.782 when BE was combined with lactate. Conclusion: Incorporating BE into mREMS provides complementary prognostic value by improving 30-day mortality discrimination among high-acuity ED patients.
