Albumin-Corrected Anion Gap And Mortality In Septic Intensive Care Patients: An Analysis Using Medical Information...

Area of Science:

• Critical Care Medicine
• Clinical Chemistry
• Epidemiology

Background:

• Early prognostic assessment is vital for sepsis patients in intensive care units (ICUs).
• The albumin-corrected anion gap (ACAG) is a potential biomarker for sepsis prognosis.
• Limited data exists on the association between ACAG and clinical outcomes in ICU sepsis.

Purpose of the Study:

• To investigate the relationship between ACAG and 30-day mortality in ICU sepsis patients.
• To identify potential threshold effects or nonlinear associations of ACAG with mortality.
• To assess the utility of ACAG as an early prognostic marker in critical care settings.

Main Methods:

• Retrospective cohort study of 8,286 sepsis patients from the MIMIC-IV database.
• Analysis using Kaplan-Meier, log-rank tests, multivariable Cox regression, and restricted cubic spline (RCS) regression.
• Primary outcomes included 30-day in-hospital and ICU mortality; subgroup analyses were performed.

Main Results:

• Higher ACAG levels were significantly associated with increased 30-day mortality risks.
• ACAG independently predicted higher in-hospital mortality (HR 1.01 per unit increase).
• The highest ACAG quartile showed significantly increased mortality risks for both in-hospital (41%) and ICU (54%) outcomes; RCS identified a nonlinear association with an inflection point at ACAG = 23.

Conclusions:

• Elevated ACAG is a significant predictor of increased 30-day mortality in ICU sepsis patients.
• A nonlinear relationship exists, with an inflection point at ACAG = 23, suggesting a potential threshold for risk.
• ACAG monitoring may enhance prognostic assessment in critically ill sepsis patients, particularly when levels exceed 23.