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血清阴离子间隙与未经选择的成年患者全因死亡率的关系:一项超过 20000 例患者的回顾性队列研究。

The association between serum anion gap and all-cause mortality of unselected adult patients: A retrospective cohort study of >20,000 patients.

机构信息

Department of Traditional Chinese Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, China.

Department of Oncology, Graduate Collaborative Training Base of The First People's Hospital of Xiangtan City, Hengyang Medical school, University of South China, Hengyang, China.

出版信息

J Clin Lab Anal. 2023 Jan;37(1):e24818. doi: 10.1002/jcla.24818. Epub 2022 Dec 22.

Abstract

BACKGROUND

Even though the serum anion gap (AG) is frequently measured in clinical practice, there is not much research that has examined long-term mortality in unselected adult patients. Our study's objective was to investigate how serum anion gap levels could be used to predict death in unselected participants.

METHODS

The relationship between baseline serum AG levels and short-, intermediate-, and long-term all-cause mortality in unselected adult patients is examined using the Cox proportional risk analysis, smoothed curve fitting, subgroup analysis, and Kaplan-Meier survival curves.

RESULTS

After screening the database using the appropriate method, a total of 26,270 patients were enrolled in our study for the final data analysis. Our study used smoothed curve fit plots and COX proportional risk regression models incorporating cubic spline functions to evaluate the association between AG levels and all-cause mortality in a non-selected population, and the results indicated a non-linear relationship. In the fully adjusted model, we found that AG levels were positively associated with 30-day, 90-day, 365-day, and 4-year all-cause mortality in unselected adult patients with HRs of 1.08 95% CIs (1.06, 1.09); 1.08 95% CIs (1.06, 1.09); 1.08 95% CIs (1.07, 1.08); 1.07 95% CIs (1.06, 1.07).

CONCLUSION

Serum anion gap levels were positively correlated with all-cause mortality in unselected adult patients, with increasing levels of serum anion gap increasing patient mortality.

摘要

背景

尽管血清阴离子间隙(AG)在临床实践中经常被测量,但很少有研究检查未选择的成年患者的长期死亡率。我们的研究目的是调查血清阴离子间隙水平如何用于预测未选择的参与者的死亡。

方法

使用 Cox 比例风险分析、平滑曲线拟合、亚组分析和 Kaplan-Meier 生存曲线检查基线血清 AG 水平与未选择的成年患者的短期、中期和长期全因死亡率之间的关系。

结果

使用适当的方法筛选数据库后,共有 26270 名患者被纳入我们的研究进行最终数据分析。我们的研究使用平滑曲线拟合图和 COX 比例风险回归模型,结合三次样条函数,评估了 AG 水平与非选择人群全因死亡率之间的关系,结果表明存在非线性关系。在完全调整模型中,我们发现 AG 水平与未选择的成年患者的 30 天、90 天、365 天和 4 年全因死亡率呈正相关,HRs 分别为 1.08(95%CI:1.06,1.09);1.08(95%CI:1.06,1.09);1.08(95%CI:1.07,1.08);1.07(95%CI:1.06,1.07)。

结论

血清阴离子间隙水平与未选择的成年患者的全因死亡率呈正相关,血清阴离子间隙水平升高与患者死亡率升高相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b017/9833973/3ee7dfb4b01c/JCLA-37-e24818-g006.jpg

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