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Association between anion gap and mortality of aortic aneurysm in intensive care unit after open surgery

BACKGROUND: There has not been a well-accepted prognostic model to predict the mortality of aortic aneurysm patients in intensive care unit after open surgery repair. Otherwise, our previous study found that anion gap was a prognosis factor for aortic aneurysm patients. Therefore, we wanted to inves...

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Autores principales: Gao, Yijing, Hong, Zilin, Shen, Runnan, Zhang, Shiran, You, Guochang, Chen, Jie, Guo, Xushun, Peng, Senyi, Huang, Kai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8459533/
https://www.ncbi.nlm.nih.gov/pubmed/34556051
http://dx.doi.org/10.1186/s12872-021-02263-4
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author Gao, Yijing
Hong, Zilin
Shen, Runnan
Zhang, Shiran
You, Guochang
Chen, Jie
Guo, Xushun
Peng, Senyi
Huang, Kai
author_facet Gao, Yijing
Hong, Zilin
Shen, Runnan
Zhang, Shiran
You, Guochang
Chen, Jie
Guo, Xushun
Peng, Senyi
Huang, Kai
author_sort Gao, Yijing
collection PubMed
description BACKGROUND: There has not been a well-accepted prognostic model to predict the mortality of aortic aneurysm patients in intensive care unit after open surgery repair. Otherwise, our previous study found that anion gap was a prognosis factor for aortic aneurysm patients. Therefore, we wanted to investigate the relationship between anion gap and mortality of aortic aneurysm patients in intensive care unit after open surgery repair. METHODS: From Medical Information Mart for Intensive Care III, data of aortic aneurysm patients in intensive care unit after open surgery were enrolled. The primary clinical outcome was defined as death in intensive care unit. Univariate analysis was conducted to compare the baseline data in different groups stratified by clinical outcome or by anion gap level. Restricted cubic spline was drawn to find out the association between anion gap level and mortality. Subgroup analysis was then conducted to show the association in different level and was presented as frost plot. Multivariate regression models were built based on anion gap and were adjusted by admission information, severity score, complication, operation and laboratory indicators. Receiver operating characteristic curves were drawn to compare the prognosis ability of anion gap and simplified acute physiology score II. Decision curve analysis was finally conducted to indicate the net benefit of the models. RESULTS: A total of 405 aortic aneurysm patients were enrolled in this study and the in-intensive-care-unit (in-ICU) mortality was 6.9%. Univariate analysis showed that elevated anion gap was associated with high mortality (P value < 0.001), and restricted cubic spline analysis showed the positive correlation between anion gap and mortality. Receiver operating characteristic curve showed that the mortality predictive ability of anion gap approached that of simplified acute physiology score II and even performed better in predicting in-hospital mortality (P value < 0.05). Moreover, models based on anion gap showed that 1 mEq/L increase of anion gap improved up to 42.3% (95% confidence interval 28.5–59.8%) risk of death. CONCLUSIONS: The level of serum anion gap was an important prognosis factor for aortic aneurysm mortality in intensive care unit after open surgery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-021-02263-4.
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spelling pubmed-84595332021-09-23 Association between anion gap and mortality of aortic aneurysm in intensive care unit after open surgery Gao, Yijing Hong, Zilin Shen, Runnan Zhang, Shiran You, Guochang Chen, Jie Guo, Xushun Peng, Senyi Huang, Kai BMC Cardiovasc Disord Research BACKGROUND: There has not been a well-accepted prognostic model to predict the mortality of aortic aneurysm patients in intensive care unit after open surgery repair. Otherwise, our previous study found that anion gap was a prognosis factor for aortic aneurysm patients. Therefore, we wanted to investigate the relationship between anion gap and mortality of aortic aneurysm patients in intensive care unit after open surgery repair. METHODS: From Medical Information Mart for Intensive Care III, data of aortic aneurysm patients in intensive care unit after open surgery were enrolled. The primary clinical outcome was defined as death in intensive care unit. Univariate analysis was conducted to compare the baseline data in different groups stratified by clinical outcome or by anion gap level. Restricted cubic spline was drawn to find out the association between anion gap level and mortality. Subgroup analysis was then conducted to show the association in different level and was presented as frost plot. Multivariate regression models were built based on anion gap and were adjusted by admission information, severity score, complication, operation and laboratory indicators. Receiver operating characteristic curves were drawn to compare the prognosis ability of anion gap and simplified acute physiology score II. Decision curve analysis was finally conducted to indicate the net benefit of the models. RESULTS: A total of 405 aortic aneurysm patients were enrolled in this study and the in-intensive-care-unit (in-ICU) mortality was 6.9%. Univariate analysis showed that elevated anion gap was associated with high mortality (P value < 0.001), and restricted cubic spline analysis showed the positive correlation between anion gap and mortality. Receiver operating characteristic curve showed that the mortality predictive ability of anion gap approached that of simplified acute physiology score II and even performed better in predicting in-hospital mortality (P value < 0.05). Moreover, models based on anion gap showed that 1 mEq/L increase of anion gap improved up to 42.3% (95% confidence interval 28.5–59.8%) risk of death. CONCLUSIONS: The level of serum anion gap was an important prognosis factor for aortic aneurysm mortality in intensive care unit after open surgery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-021-02263-4. BioMed Central 2021-09-23 /pmc/articles/PMC8459533/ /pubmed/34556051 http://dx.doi.org/10.1186/s12872-021-02263-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Gao, Yijing
Hong, Zilin
Shen, Runnan
Zhang, Shiran
You, Guochang
Chen, Jie
Guo, Xushun
Peng, Senyi
Huang, Kai
Association between anion gap and mortality of aortic aneurysm in intensive care unit after open surgery
title Association between anion gap and mortality of aortic aneurysm in intensive care unit after open surgery
title_full Association between anion gap and mortality of aortic aneurysm in intensive care unit after open surgery
title_fullStr Association between anion gap and mortality of aortic aneurysm in intensive care unit after open surgery
title_full_unstemmed Association between anion gap and mortality of aortic aneurysm in intensive care unit after open surgery
title_short Association between anion gap and mortality of aortic aneurysm in intensive care unit after open surgery
title_sort association between anion gap and mortality of aortic aneurysm in intensive care unit after open surgery
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8459533/
https://www.ncbi.nlm.nih.gov/pubmed/34556051
http://dx.doi.org/10.1186/s12872-021-02263-4
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