Serum anion gap is associated with all-cause mortality among critically ill patients with congestive heart failure

Abstract

AbstractBackgroundCongestive heart failure (CHF) is a complex clinical syndrome, with high morbidity and mortality. Serum anion gap (SAG) has been known to be associated with the severity of various cardiovascular diseases. However, the role of SAG indicators in CHF is unclear.Methods and resultsA retrospective analysis of data from MIMIC-III v1.4 was conducted in critically ill patients with CHF. Clinical information of each patient, including demographic data, comorbidities, vital signs, scores, and laboratory indicators, were successfully obtained. Cox proportional hazards models were performed to determine the relationship between SAG and mortality in CHF patient, the consistency of which was further verified by subgroup analysis.ResultsA total of 7426 subjects met the inclusion criteria. In multivariate analysis, after adjusting for age, gender, ethnicity, and other potential confounders, higher SAG was significantly related to an increase in 30-day and 90-day all-cause mortality of critically ill patients with CHF compared with lower SAG (tertile3 vs tertile1: adjusted HR, 95% CI: 1.74, 1.46–2.08; 1.53, 1.32–1.77). In subgroup analysis, the association between SAG and all-cause mortality present similarities in most strata.ConclusionSAG at admission can be a promising predictor of all-cause mortality in critically ill patients with CHF.