Back to Journals » International Journal of General Medicine » Volume 14

The Relationship Between the Serum Anion Gap and All-Cause Mortality in Acute Pancreatitis: An Analysis of the MIMIC-III Database

Authors Gong F, Zhou Q, Gui C, Huang S, Qin Z

Received 22 November 2020

Accepted for publication 25 January 2021

Published 19 February 2021 Volume 2021:14 Pages 531—538

DOI https://doi.org/10.2147/IJGM.S293340

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser


Fang Gong,1 Quan Zhou,2 Chunmei Gui,1 Shaohua Huang,1 Zuoan Qin3

1Department of Intensive Care Unit, The First People’s Hospital of Changde, Changde City, Hunan Province, 415000, People’s Republic of China; 2Department of Science and Education Section, The First People’s Hospital of Changde, Changde City, Hunan Province, 415000, People’s Republic of China; 3Cardiovascular Medicine Department, The First People’s Hospital of Changde, Changde City, Hunan Province, 415000, People’s Republic of China

Correspondence: Fang Gong
Department of Intensive Care Unit, The First People’s Hospital of Changde, 818 Renmin Road, Changde City, Hunan Province, 415000, People’s Republic of China
Tel +86-0736-7788035
Email gficu2009@163.com

Purpose: We aimed to investigate the relationship between the serum anion gap (AG) and all-cause mortality in patients with acute pancreatitis (AP) in intensive care units (ICUs).
Patients and Methods: In this retrospective cohort analysis, data of patients with AP were extracted from the Medical Information Mart for Intensive Care database (version III). We collected the maximum serum AG value within the first 24 hours of ICU admission. The main outcome was 90-day all-cause mortality. A multivariate Cox proportional hazard regression model was used to examine the association between the serum AG and mortality. The restricted cubic spline curve was used to confirm a non-linear relationship between serum AG values and mortality.
Results: Of the 279 patients included in the study, 87 (31.18%) died. The serum AG value was positively associated with 90-day all-cause mortality (hazard ratio [HR] 1.08, 95% confidence interval [CI] 1.02– 1.14), after adjusting for age, sex, alcohol consumption, congestive heart failure, diabetes mellitus, hypertension, eGFR, albumin, and the SOFA score. There was a non-linear relationship between serum AG values and mortality after adjusting for potential confounders. We used a two-piecewise regression model to obtain a threshold inflection point value of 13.8 mmol/L. The HR and the 95% CI on the left inflection point were 0. 82 (0.61– 1.09; p = 0.1719), and on the right inflection point were 1.15 (1.08– 1.23; p < 0.0001).
Conclusion: The relationship between all-cause mortality in patients with acute pancreatitis and serum AG values was non-linear. All-cause mortality and serum AG values were positively correlated when the serum AG value was > 13.8 mmol/L.

Keywords: anion gap, all-cause mortality, acute pancreatitis, MIMIC III database

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]