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. 2021 Oct 4;11(10):1004.
doi: 10.3390/jpm11101004.

Plasma Anion Gap and Risk of In-Hospital Mortality in Patients with Acute Ischemic Stroke: Analysis from the MIMIC-IV Database

Hong-Jie Jhou  1   2 , Po-Huang Chen  3 , Li-Yu Yang  1   2 , Shu-Hao Chang  4 , Cho-Hao Lee  5
Affiliations

Plasma Anion Gap and Risk of In-Hospital Mortality in Patients with Acute Ischemic Stroke: Analysis from the MIMIC-IV Database

Hong-Jie Jhou et al. J Pers Med. .

Abstract

We aimed to investigate the association between the plasma anion gap (AG) and in-hospital mortality among patients with acute ischemic stroke (AIS). In total, 1236 AIS patients were enrolled using the Medical Information Mart for Intensive Care Database IV. Primary outcome was in-hospital mortality. The patients were divided into four groups according to AG category. The mean age and Charlson comorbidity index increased as the AG category increased. The fourth AG category was most related to the in-hospital mortality (hazards ratio (HR), 95% confidence interval (CI): 2.77, 1.60-4.71), even after adjusting for possible confounding variables (Model 1: HR, 95% CI: 3.37, 1.81-6.09; Model 2: HR, 95% CI: 3.57, 1.91-6.69). Moreover, intensive care unit mortality (p = 0.008) was higher in the highest AG category, but the intracranial hemorrhage (p = 0.071) did not associate with the plasma AG. The plasma AG had a satisfactory predictive ability for in-hospital mortality among AIS patients (areas under the receiver operating characteristic curve: 0.631). The plasma AG is an independent risk factor that can satisfactorily predict the in-hospital mortality among AIS patients.

Keywords: MIMIC-IV; anion gap; intensive care unit; ischemic stroke.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study patients.
Figure 2
Figure 2
Relationship between the plasma AG and the risk of ICU and in-hospital mortality. Shaded areas around the curves depict 95% confidence intervals. AG: anion gap; ICU: intensive care unit.
Figure 3
Figure 3
Kaplan–Meier curves indicating the association between the AG category and in-hospital mortality. Red line: first category. Green line: second category. Blue line: third category. Purple line: fourth category. AG: anion gap.
Figure 4
Figure 4
Receiver operating characteristic curves for the prediction of the in-hospital mortality in critically ill patients with ischemic stroke. (A) The ability of the SIRS score, SOFA score, and AG to predict in-hospital mortality. (B) The ability of different AG category to predict in-hospital mortality. AG: anion gap; SIRS: systemic inflammatory response syndrome; SOFA: sequential organ failure assessment score.
See this image and copyright information in PMC

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