Serum Anion Gap at Admission Predicts All-Cause Mortality in Critically Ill Patients With Cirrhosis: A Retrospective Cohort Study.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Clinical and Translational Gastroenterology Pub Date : 2024-09-01 DOI:10.14309/ctg.0000000000000734

Yanqi Kou, Shenshen Du, Mingcheng Zhang, Biao Nie, Weinan Yuan, Kun He, Ling Qin, Shicai Ye, Yuping Yang

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Abstract

Introduction: The primary objective of this study was to evaluate admission serum anion gap (AG) as a predictor of all-cause mortality in critically ill patients with cirrhosis.

Methods: A total of 3,084 cirrhotic patients were included and randomly divided into training and validation cohorts (n = 2,159 and 925, respectively). Patients were categorized into high and normal AG groups based on their AG values. Cox regression and Kaplan-Meier survival analysis were used to assess the relationships between AG levels and outcomes.

Results: Both cohorts showed strong parameter similarity ( P > 0.05). High AG was associated with significantly lower survival probabilities. Cox models confirmed elevated AG as a risk factor, even after adjusting for covariates (hazard ratio: 1.920, 1.793, and 1.764 for 30-day, 60-day, and hospital mortality, respectively). Subgroup analyses, especially regarding chronic kidney disease, revealed complex interactions. Serum AG displayed predictive power comparable with established scoring systems.

Discussion: Elevated AG at admission is a valuable predictor of poor outcomes and increased mortality risk in critically ill cirrhotic patients. Serum AG can serve as an easily accessible tool for risk assessment and prognosis evaluation in this population.

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入院时的血清阴离子差距可预测肝硬化重症患者的全因死亡率：一项回顾性队列研究。

背景和目的：本研究的主要目的是评估肝硬化重症患者入院时血清阴离子差距（AG）作为全因死亡率的预测指标：本研究的主要目的是评估入院血清阴离子间隙（AG）作为肝硬化重症患者全因死亡率预测指标的作用：共纳入 3,084 名肝硬化患者，并随机分为训练组和验证组（分别为 2,159 人和 925 人）。根据 AG 值将患者分为高 AG 组和正常 AG 组。采用 Cox 回归和 Kaplan-Meier 生存分析评估 AG 水平与预后之间的关系：结果：两组患者的参数具有很强的相似性（P > 0.05）。高AG与明显较低的生存概率相关。Cox 模型证实 AG 升高是一个风险因素，即使在调整协变量后也是如此（30 天、60 天和住院死亡率的 HR 分别为 1.920、1.793 和 1.764）。亚组分析，尤其是有关慢性肾病的亚组分析，显示了复杂的相互作用。血清AG的预测能力与已建立的评分系统相当：结论：入院时 AG 升高是预测肝硬化重症患者不良预后和增加死亡风险的重要指标。血清AG可作为该人群风险评估和预后评价的便捷工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.00

自引率

0.00%

发文量

114

审稿时长

16 weeks

期刊介绍： Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.