The prediction value of serum anion gap for short-term mortality in pulmonary hypertension patients with sepsis: a retrospective cohort study
BackgroundThe relationship between anion gap (AG) and short-term mortality of pulmonary hypertension (PH) patients with sepsis in the intensive care unit (ICU) remains unclear.MethodsThis study involved a retrospective analysis of incident PH patients with sepsis first admitted to the ICU in the MIM...
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Frontiers Media S.A.
2025-01-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2024.1499677/full |
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| author | Jinhua Zhu Zeying Zhang Yefei Lei Zhenrong Ouyang Shelby Kutty Qiming Liu Yunbin Xiao Yunbin Xiao |
| author_facet | Jinhua Zhu Zeying Zhang Yefei Lei Zhenrong Ouyang Shelby Kutty Qiming Liu Yunbin Xiao Yunbin Xiao |
| author_sort | Jinhua Zhu |
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| description | BackgroundThe relationship between anion gap (AG) and short-term mortality of pulmonary hypertension (PH) patients with sepsis in the intensive care unit (ICU) remains unclear.MethodsThis study involved a retrospective analysis of incident PH patients with sepsis first admitted to the ICU in the MIMIC IV database (2008 to 2019). Short-term outcomes include in-hospital mortality and 28-day mortality. According to the AG value (17.0 mmol/L), patients were divided into high-AG and low-AG groups. The Kaplan–Meier survival curve was used to compare the cumulative survival rates of the high and low groups using the log-rank test. Multivariable Cox regression analyses were constructed to assess the relationship between AG and short-term outcomes in PH patients with sepsis.ResultsA total of 2,012 sepsis patients with PH were included. The in-hospital mortality rates (11.4%) and 28-day mortality rates (12.8%) in the high-AG group were higher than those in the low-AG group (5.0% or 7.2%, respectively; P < 0.001). The Kaplan–Meier curve showed that the in-hospital and 28-day cumulative survival rates were lower in the high-AG group than in the low-AG group (P < 0.001). The multivariable Cox regression analysis confirmed that elevated AG was an independent risk factor of in-hospital mortality, 28-day mortality, and length of stay in the ICU and hospital. The relationship between elevated AG and in-hospital mortality remains stable after subgroup analyses.ConclusionElevated serum AG is associated with increased risk-adjusted short-term mortality in PH patients with sepsis, and it may aid clinicians in identifying patients with poor prognosis as early as possible. |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-1f2cd1900f48459a8af83e902c9ebc0d2025-01-07T15:00:22ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011110.3389/fmed.2024.14996771499677The prediction value of serum anion gap for short-term mortality in pulmonary hypertension patients with sepsis: a retrospective cohort studyJinhua Zhu0Zeying Zhang1Yefei Lei2Zhenrong Ouyang3Shelby Kutty4Qiming Liu5Yunbin Xiao6Yunbin Xiao7Department of Pediatric Intensive Care Unit, The First People's Hospital of Chenzhou Affiliated to Jinan University, Chenzhou, ChinaDepartment of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, ChinaDepartment of Pediatric Intensive Care Unit, The First People's Hospital of Chenzhou, Chenzhou, Hunan, ChinaDepartment of Pediatric Intensive Care Unit, The First People's Hospital of Chenzhou, Chenzhou, Hunan, ChinaPediatric and Congenital Cardiology, Taussig Heart Center, Johns Hopkins School of Medicine, Baltimore, MD, United StatesDepartment of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Cardiology, Hunan Children's Hospital Affiliated to Jinan University, Changsha, ChinaDepartment of Cardiology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, ChinaBackgroundThe relationship between anion gap (AG) and short-term mortality of pulmonary hypertension (PH) patients with sepsis in the intensive care unit (ICU) remains unclear.MethodsThis study involved a retrospective analysis of incident PH patients with sepsis first admitted to the ICU in the MIMIC IV database (2008 to 2019). Short-term outcomes include in-hospital mortality and 28-day mortality. According to the AG value (17.0 mmol/L), patients were divided into high-AG and low-AG groups. The Kaplan–Meier survival curve was used to compare the cumulative survival rates of the high and low groups using the log-rank test. Multivariable Cox regression analyses were constructed to assess the relationship between AG and short-term outcomes in PH patients with sepsis.ResultsA total of 2,012 sepsis patients with PH were included. The in-hospital mortality rates (11.4%) and 28-day mortality rates (12.8%) in the high-AG group were higher than those in the low-AG group (5.0% or 7.2%, respectively; P < 0.001). The Kaplan–Meier curve showed that the in-hospital and 28-day cumulative survival rates were lower in the high-AG group than in the low-AG group (P < 0.001). The multivariable Cox regression analysis confirmed that elevated AG was an independent risk factor of in-hospital mortality, 28-day mortality, and length of stay in the ICU and hospital. The relationship between elevated AG and in-hospital mortality remains stable after subgroup analyses.ConclusionElevated serum AG is associated with increased risk-adjusted short-term mortality in PH patients with sepsis, and it may aid clinicians in identifying patients with poor prognosis as early as possible.https://www.frontiersin.org/articles/10.3389/fmed.2024.1499677/fullanion gapintensive care unitmortalitypulmonary hypertensionsepsis |
| spellingShingle | Jinhua Zhu Zeying Zhang Yefei Lei Zhenrong Ouyang Shelby Kutty Qiming Liu Yunbin Xiao Yunbin Xiao The prediction value of serum anion gap for short-term mortality in pulmonary hypertension patients with sepsis: a retrospective cohort study Frontiers in Medicine anion gap intensive care unit mortality pulmonary hypertension sepsis |
| title | The prediction value of serum anion gap for short-term mortality in pulmonary hypertension patients with sepsis: a retrospective cohort study |
| title_full | The prediction value of serum anion gap for short-term mortality in pulmonary hypertension patients with sepsis: a retrospective cohort study |
| title_fullStr | The prediction value of serum anion gap for short-term mortality in pulmonary hypertension patients with sepsis: a retrospective cohort study |
| title_full_unstemmed | The prediction value of serum anion gap for short-term mortality in pulmonary hypertension patients with sepsis: a retrospective cohort study |
| title_short | The prediction value of serum anion gap for short-term mortality in pulmonary hypertension patients with sepsis: a retrospective cohort study |
| title_sort | prediction value of serum anion gap for short term mortality in pulmonary hypertension patients with sepsis a retrospective cohort study |
| topic | anion gap intensive care unit mortality pulmonary hypertension sepsis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2024.1499677/full |
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