Albumin Corrected Anion Gap and the Risk of in-Hospital Mortality in Patients with Acute Pancreatitis: A Retrospective Cohort Study

Li, Ping; Shi, Lvyuan; Yan, Xin; Wang, Lietao; Wan, Dingyuan; Zhang, Zhongwei; He, Min

doi:10.2147/jir.s412860

Cited by 13 publications

(10 citation statements)

References 30 publications

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“…We demonstrated in this study that ACAG has a better predictive value than AG in the prognostic prediction of S-AKI, which implies that ACAG may be an excellent alternative variable in constructing a scoring system. Meanwhile, the advantage of ACAG over AG may not be an isolated case, but may also be a pattern in other diseases (some studies have already confirmed this, including sepsis [ 20 ], acute pancreatitis [ 21 ], and acute myocardial infarction [ 22 ]), and our study provides more evidence for subsequent studies. Furthermore, this advantage of ACAG over AG has some value in the clinic, and perhaps, in the future, ACAG could be a direct substitute for AG in certain diseases.…”

Section: Discussionsupporting

confidence: 56%

Association Between Albumin-Corrected Anion Gap and In-Hospital Mortality and Sepsis-Associated Acute Kidney Injury

Guo,

Wang

2023

Med Sci Monit

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Background This study aimed to investigate the association between albumin-corrected anion gap (ACAG) and in-hospital mortality in sepsis-associated acute kidney injury (S-AKI). Material/Methods We conducted this retrospective study based on data from the Medical Information Mart for Intensive Care IV database, and assessed the prognostic capabilities of ACAG in comparison with albumin (ALB) and anion gap (AG) to predict in-hospital mortality of patients with S-AKI. Binomial logistic regression analysis was performed to identify whether ACAG was an independent risk factor for in-hospital mortality for the patients, and receiver operating characteristic (ROC) curves were plotted to clarify its efficacy in predicting in-hospital mortality. We also performed a decision curve analysis (DCA) to determine whether there were net clinical benefits for patients when ACAG was used to predict in-hospital mortality. Results Binary logistic regression analysis showed that ACAG was an independent risk factor for in-hospital mortality in patients with S-AKI, with an area under the ROC (AUC) curve of 0.675 (moderate predictive value) for the prediction of in-hospital mortality, higher than that of ALB or AG alone, with the highest Youden’s index (0.2675). The DCA substantiated the superiority of ACAG in net clinical benefits at various threshold probability, enhancing its clinical applicability. Conclusions The research emphasizes the potential of ACAG as a valuable predictive tool for in-hospital mortality in S-AKI patients, which is better than albumin and AG, encouraging its consideration in clinical practice.

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Section: Discussionsupporting

confidence: 56%

Association Between Albumin-Corrected Anion Gap and In-Hospital Mortality and Sepsis-Associated Acute Kidney Injury

Guo,

Wang

2023

Med Sci Monit

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“…16 Li et al conducted a study on 344 patients with acute pancreatitis and found that higher ACAG was independently associated with higher in-hospital mortality in patients with acute pancreatitis. 30 The study conducted by Zhong et al on critically ill patients with AKI undergoing continuous RRT (CRRT) demonstrated a significant correlation between higher ACAG levels (>20 mmol/L) at the initiation of CRRT and all-cause mortality in the ICU. 18 A recent study has indicated that elevated ACAG levels are associated with an increased risk of all-cause mortality during hospitalization in patients with CA.…”

Section: Discussionmentioning

confidence: 99%

The correlation between albumin‐corrected anion gap and prognosis in patients with acute myocardial infarction

Sheng,

Lu,

Zhong

et al. 2024

ESC Heart Failure

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AimsAcute myocardial infarction (AMI) is a cardiovascular disease with high morbidity and mortality. We collected patients with AMI from the Medical Information Mart for Intensive Care IV (v2.0) database and explored the association between serum albumin‐corrected anion gap (ACAG) level and mortality in patients with AMI.Methods and resultsData of adult patients with AMI were collected. According to the 360 day prognosis, patients were divided into survival and non‐survival groups. Based on the ACAG level, patients were then divided into normal and high ACAG groups. Cox hazard proportional models and restricted cubic splines (RCSs) were used to investigate the correlation between ACAG and mortality. Kaplan–Meier curves were created to compare the cumulative survival rates between the high and normal ACAG groups. The receiver operating characteristic (ROC) curve was used to analyse the predictive value of ACAG for the prognosis of patients with AMI. Sensitivity and subgroup analyses were conducted to revalidate the results. Finally, 1783 patients were included. Elevated ACAG (>20 mmol/L) was significantly associated with 30 and 360 day mortality (P < 0.001). Adjusted for multiple confounding factors, the Cox proportional hazard analysis showed that elevated ACAG (>20 mmol/L) was an independent risk factor of increased all‐cause mortality in patients with AMI (hazard ratio 1.423, 95% confidence interval 1.206–1.678, P < 0.001). RCS analysis further showed that there was a non‐linear trend relationship between ACAG and the risk of all‐cause mortality at 30 and 360 days (χ2 = 10.750, P = 0.013; χ2 = 13.960, P = 0.003). Kaplan–Meier survival curves showed that the 30 and 360 day cumulative survival rates of patients with AMI were significantly lower (log‐rank test, χ2 = 98.880, P < 0.001; χ2 = 105.440, P < 0.001) in the high ACAG group. ROC curve analysis showed that the area under the curve (AUC) of ACAG was 0.651, while the AUC of anion gap (AG) was 0.609, indicating that ACAG had a higher predictive value for 360 day mortality than AG. When combined with Sequential Organ Failure Assessment score, the predictive performance of ACAG for 360 day mortality was better, with an AUC of 0.699. Sensitivity and subgroup analyses were conducted suggesting the stability of our results.ConclusionsElevated serum ACAG (≥20 mmol/L) is an independent risk factor for short‐term and long‐term mortality in critically ill patients with AMI, and it may assist clinicians and nurses identifying high‐risk patients.

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“…If there were multiple measurements of an index within 24 h, the mean value was taken to ensure accuracy. ACAG was calculated using the formula 10 : ACAG (mmol/l) = AG (mmol/l) + [4.4 − albumin (g/dl)] * 2.5, to adjust for the influence of albumin levels. The primary outcome of interest in this study was 30-d mortality in patients diagnosed with asthma.…”

Section: Methodsmentioning

confidence: 99%

“…Although AG is closely related to asthma, the level of AG is greatly affected by the level of albumin 10 , every 1 g/dl decrease in albumin concentration, AG will decrease about 2.5 mmol/L, hypoproteinemia can make AG false negative results. In addition, the use of AG in such patients with abnormal albumin levels is limited because albumin levels are often reduced in patients with asthma 11 .…”

Section: Introductionmentioning

confidence: 99%

The relationship between albumin corrected anion gap levels and mortality in patients with asthma in the ICU

Wang,

Teng,

Han

et al. 2023

Sci Rep

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Although previous studies have suggested that albumin-corrected anion gap (ACAG) may be a predictor of mortality in critically ill patients in intensive care unit (ICU), its utility in the context of asthma has not been definitively established. In this study, baseline data, albumin concentration, anion gap (AG) and 30-d mortality data were retrieved from the Medical Information Mart for Intensive Care IV database (MIMIC-IV) for patients with asthma in the intensive care unit. Receiver operating characteristic (ROC) curves were constructed to analyze the predictive ability of ACAG and AG. The risk of 30-day mortality among patients with ACAG and asthma was analyzed using a restricted cubic spline (RCS) plot. Decision curve analysis (DCA) was used to evaluate the clinical usefulness of ACAG as a prognostic factor for 30-day mortality. Subsequently, subgroup analysis was conducted to explore potential variations in the relationship between ACAG and 30-day mortality based on factors such as sex, age, whether the asthma was acute, and other co-morbidities. Our study reveals that ACAG is a significant independent predictor of 30-day mortality in asthmatic patients receiving intensive care. The area under the AUC curve for ACAG was found to be 0.703, which is higher than that of AG, indicating that ACAG has a better predictive ability for 30-day mortality in this population. Furthermore, higher levels of ACAG were found to be associated with increased risk of 30-day mortality in asthmatic patients. In addition, decision curve analysis (DCA) demonstrated that the net benefit of ACAG was greater than that of AG. These findings suggest that ACAG may be a valuable prognostic factor for predicting 30-day mortality in asthmatic patients in the ICU. Our study provides evidence that ACAG is associated with an increased risk of 30-d mortality and has better predictive value in patients with combined asthma who are admitted to the ICU than AG.

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Albumin Corrected Anion Gap and the Risk of in-Hospital Mortality in Patients with Acute Pancreatitis: A Retrospective Cohort Study

Cited by 13 publications

References 30 publications

Association Between Albumin-Corrected Anion Gap and In-Hospital Mortality and Sepsis-Associated Acute Kidney Injury

Association Between Albumin-Corrected Anion Gap and In-Hospital Mortality and Sepsis-Associated Acute Kidney Injury

The correlation between albumin‐corrected anion gap and prognosis in patients with acute myocardial infarction

The relationship between albumin corrected anion gap levels and mortality in patients with asthma in the ICU

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