入院时血清阴离子间隙预测脑梗死危重症患者的全因死亡率：来自 MIMIC-III 数据库的证据。
Serum anion gap at admission predicts all-cause mortality in critically ill patients with cerebral infarction: evidence from the MIMIC-III database.
机构信息
Department of Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Program & Department of Clinical Laboratory Medicine, Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China.
出版信息
Biomarkers. 2020 Dec;25(8):725-732. doi: 10.1080/1354750X.2020.1842497. Epub 2020 Nov 10.
BACKGROUND
Recent studies reported that serum anion gap could be regarded as a prognostic biomarker for patients admitted to intensive care units. However, the association between AG and mortality in cerebral infarction patients remained largely unknown.
METHODS
Relevant clinical data were collected from Medical Information Mart for Intensive Care III. Patients were divided into three groups according to tertiles of AG. Kaplan-Meier curve and Cox proportional hazards models were used to evaluate the association between AG levels and all-cause mortality. Subgroup analyses were performed to verify the predictive role of AG on mortality.
RESULTS
Kaplan-Meier analysis showed that patients with higher AG had shorter survival time. Cox regression model indicated high AG as an independent risk factor of 30-day, 60-day and 180-day all-cause mortality (30-day: HR = 2.45, 95% CI = 1.21-4.97, 60-day: HR = 2.04, 95% CI = 1.07-3.89, and 180-day: HR = 1.85, 95% CI = 1.02-3.36). However, no significance was observed between AG and 365-day all-cause mortality (HR = 1.56, 95% CI = 0.87-2.78).
CONCLUSIONS
High AG was associated with increased risk of all-cause mortality, and AG could be an independent short-term prognostic factor for cerebral infarction.
背景
最近的研究报告称，血清阴离子间隙（AG）可作为重症监护病房（ICU）患者的预后生物标志物。然而，AG 与脑梗死患者死亡率之间的关系在很大程度上仍不清楚。
方法
从医疗信息重症监护 III 中收集相关临床数据。根据 AG 的三分位将患者分为三组。采用 Kaplan-Meier 曲线和 Cox 比例风险模型评估 AG 水平与全因死亡率之间的关系。进行亚组分析以验证 AG 对死亡率的预测作用。
结果
Kaplan-Meier 分析表明，AG 较高的患者生存时间较短。Cox 回归模型表明，高 AG 是 30 天、60 天和 180 天全因死亡率的独立危险因素（30 天：HR = 2.45，95%CI = 1.21-4.97，60 天：HR = 2.04，95%CI = 1.07-3.89，180 天：HR = 1.85，95%CI = 1.02-3.36）。然而，AG 与 365 天全因死亡率之间无显著相关性（HR = 1.56，95%CI = 0.87-2.78）。
结论
高 AG 与全因死亡率增加相关，AG 可能是脑梗死的独立短期预后因素。
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