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Relationship between serum anion gap and mortality in ICU in multiple myeloma patients in the MIMIC database: A
Qianhui Wang1, Pengyu Hu2, Haibo Cong2
1The First Clinical Medical College of Shandong University of Traditional Chinese Medicine, Jinan, China.
Background:
Serum anion gap has diagnostic value in patients with multiple myeloma, but its association with ICU mortality and threshold value remain unclear.
Methods:
Multiple myeloma patients meeting criteria were selected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The exposure factor was serum anion gap, and the outcome was ICU in-hospital mortality. Multivariable-adjusted Cox regression, curve fitting, and forest plots were used to evaluate the relationship between anion gap and ICU mortality in multiple myeloma patients.
Results:
A total of 323 eligible subjects were included (206 males [63.8%], 117 females [36.2%]). Multivariable Cox regression showed that each 1-unit increase in AG was associated with a 7% increased mortality risk (HR = 1.07, 95%CI = 1.01-1.14, P = 0.032). Curve fitting revealed a nonlinear relationship between anion gap and ICU mortality (nonlinear P = 0.038), with the lowest risk at 15.29 mmol/L. Incorporating AG into traditional risk factor models improved mortality prediction (P = 0.038).
Conclusion:
Serum anion gap exhibits a nonlinear relationship with ICU mortality in multiple myeloma patients, with the lowest risk observed at approximately 15.29 mmol/L.
