Relationship of Admission Serum Anion Gap and Prognosis of Critically Ill Patients: A Large Multicenter Cohort Study

作者：Ruohan Li, Xuting Jin, Jiajia Ren, Guorong Deng, Jiamei Li, Ya Gao, Jingjing Zhang, Linyun Du, Jueheng Liu, Xiu Liu, Xiaochuang Wang, Gang Wang · 发表于：Disease Markers · 年份：2022 · DOI：10.1155/2022/5926049 · 被引用次数：20 · 研究领域：Renal function and acid-base balance、Vitamin C and Antioxidants Research、Chemical and Physical Studies

Background. There were controversies over the relationship between Anion gap (AG) and mortality in critically ill patients. Therefore, a large multicenter cohort study was conducted to evaluate the association of AG and mortality in large-scale intensive care units (ICUs) patients. Methods. This retrospective cohort study included adult ICU patients enrolled from eICU Collaborative Research Database. According to initial serum AG upon ICU admission, patients were divided into three groups: AG < 8 mmol / L , 8 ≤ AG ≤ 16 mmol / L , and AG > 16 mmol / L . Logistic regression models were built to investigate the association between serum AG and ICU and hospital mortalities. Serum AG was added into Acute Physiology and Chronic Health Evaluation (APACHE) IV score and the model discrimination was assessed by the area under the curve (AUC) of receiver operating characteristic curves. The relationship between serum AG and mortalities in patients with different acid-base status and serum lactate were also evaluated. An external validation was performed with the Critical care database comprising patients with infection at Zigong Fourth People’s Hospital. Results. A total of 8520 patients entered the final cohort. There are 42 patients with serum AG < 8 mmol / L , 3238 patients with 8 ≤ AG ≤ 16 mmol / L , and 5240 patients with AG > 16 mmol / L ...