Cai Jing, Pu Lin, Yuan Nanbing, Liu Meng, Lin Ken, Gao Jie, Li Jingjing
Department of Endocrinology and Metabolism, Chengdu First People's Hospital, No.18 North Vientiane Road, High-Tech Zone, Chengdu, 610000, Sichuan, China.
Department of Respiratory and Critical Care Medicine, Chengdu First People's Hospital, Chengdu, 610000, Sichuan, China.
Sci Rep. 2024 Dec 28;14(1):31275. doi: 10.1038/s41598-024-82700-4.
We aimed to determine the association between anion gap-to-calcium ratio (ACR) and 30-day mortality in sepsis patients with diabetes mellitus (DM). Data for sepsis patients diagnosed with DM was extracted from Medical Information Mart for Intensive Care Database IV. After screening, 4429 eligible subjects were included in our study finally. The receiver operating characteristic (ROC) curve was used to determine the cut-off value. According to the ROC curve analysis, the ACR demonstrated a higher area under the curve (AUC) of 0.622 compared to AG (0.598). Multivariable logistic regression with inverse probability of treatment weighting (IPTW) based on propensity score were used to detect the association between ACR and 30-day mortality. Our results showed that the patients with the high level of ACR had a higher risk of death within 30 days compared with those with low level of ACR (odds ratio 1.342, 95% confidence interval 1.180-1.526, P < 0.001). In a word, our results suggest that ACR may be an independent prognostic indicator for death with 30 days in critically ill patients with sepsis and DM.
我们旨在确定糖尿病（DM）脓毒症患者的阴离子间隙与钙比值（ACR）和30天死亡率之间的关联。诊断为DM的脓毒症患者的数据从重症监护医学信息数据库IV中提取。经过筛选，最终4429名符合条件的受试者被纳入我们的研究。受试者工作特征（ROC）曲线用于确定临界值。根据ROC曲线分析，与阴离子间隙（AG）（0.598）相比，ACR显示出更高的曲线下面积（AUC），为0.622。采用基于倾向评分的逆概率处理加权（IPTW）多变量逻辑回归来检测ACR与30天死亡率之间的关联。我们的结果表明，与ACR水平低的患者相比，ACR水平高的患者在30天内死亡风险更高（优势比1.342，95%置信区间1.180-1.526，P＜0.001）。总之，我们的结果表明，ACR可能是患有脓毒症和DM的重症患者30天死亡的独立预后指标。
