Association between albumin corrected anion gap and 30-day all-cause mortality of critically ill patients with acute myocardial infarction: a retrospective analysis based on the MIMIC-IV database

Jian, Linhao; Zhang, Zhixiang; Zhou, Quan; Duan, Xiangjie; Xu, Haiqin; Ge, Lan

doi:10.1186/s12872-023-03200-3

Cited by 13 publications

(9 citation statements)

References 33 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: 55%

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: 55%

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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“… 22 A study similar to our research got the conclusion that ACAG and 30 day all‐cause mortality had a non‐linear relationship, and ACAG had better predictive value in predicting 30 day all‐cause mortality of patients with AMI than the AG. 20 The final inclusion of this article encompassed 2160 eligible patients. The differences in the number of included individuals between our study and this article may be attributed to variations in data collection periods and methods for obtaining AG.…”

Section: Discussionmentioning

confidence: 99%

“…AG, like other laboratory indicators, was directly extracted from the MIMIC database, which was different from previous literature, 20 where AG was calculated using indicators such as sodium, chloride, and bicarbonate. The direct acquisition of AG in this study avoids confounding factors caused by these indicators not being measured at the same time point.…”

Section: Methodsmentioning

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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“…A study by Linhao Jian et al. [ 22 ] revealed that ACAG was more effective than AG in predicting 30-d mortality in ICU patients with acute myocardial infarction (AMI).…”

Section: Introductionmentioning

confidence: 99%

Association between albumin corrected anion gap and all-cause mortality in critically ill patients with acute kidney injury: a retrospective study based on MIMIC-IV database

Gao,

Min,

Zhong

et al. 2023

Renal Failure

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Background The early identification of patients at high risk for acute kidney injury (AKI) with a poor prognosis is crucial to prevent complications and minimize mortality. This study sought to investigate the association between albumin-corrected anion gap (ACAG) and all-cause mortality among critically ill patients with AKI. Methods All eligible AKI patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV version 2.0) database were considered for participation in this study. We employed Kaplan–Meier curves to assess the 30-d and 360-d cumulative survival rates among various groups. Flexibly visualizing the connection between ACAG and mortality, we utilize restricted cubic splines (RCS) and multivariate Cox regression models. Result robustness underwent assessment through subgroup analyses and sensitivity analyses. Receiver-operating characteristic (ROC) curves were generated to evaluate the predictive performance of ACAG. Results The study included 9625 AKI participants, of whom 58.60% were male, and the 360-d all-cause mortality rate was 39.89%. According to Kaplan–Meier analysis, the 30-d and 360-d cumulative survival rates for AKI patients were significantly lower in the high ACAG group than in the normal ACAG group. RCS analysis indicated that ACAG levels had a non-linear correlation with the risk of 30-d and 360-d mortality for AKI patients. Cox regression analysis demonstrated that ACAG is an independent risk indicator for 30-d and 360-d prognosis in AKI patients in the ICU. Conclusions Elevated ACAG levels (> 20 mmol/L) at ICU admission were associated with 30-d and 360-d all-cause mortality in critically ill patients with AKI.

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Association between albumin corrected anion gap and 30-day all-cause mortality of critically ill patients with acute myocardial infarction: a retrospective analysis based on the MIMIC-IV database

Cited by 13 publications

References 33 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

Association between albumin corrected anion gap and all-cause mortality in critically ill patients with acute kidney injury: a retrospective study based on MIMIC-IV database

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