The Anion Gap and Mortality in Critically Ill Patients with Hip Fractures

Abstract

Objectives. Epidemiological evidence suggests that anion gap (AG) has been reported to serve as an independent predictor for mortality in different diseases. We studied the effect of AG on both short and long-term mortalities in critically ill patients with hip fracture. Methods. A large clinical database was utilized to perform retrospective cohort analysis. AG was subdivided into three groups. The Cox proportional hazards regression model was employed to approximate the hazard ratio (HR) with a confidence interval (CI) of 95% for the link between AG and mortality. 30-day mortality is the primary outcome, while 90-day and 1-year mortalities represented our secondary outcomes for this study. Results. The participants in this study were that who provided essential data on AG and the number of patients with hip fractures was 395, and they were all aged ≥16 years. The participants comprised 199 (50.4%) females as well as 196 (49.6%) males with an average age of 71.9 ± 19.4 years, and a mean AG of 12.4 ± 3.3 gmEq/L. According to an unadjusted model for 30-day all-cause mortality, the HR (95% CI) of AG ≥ 12.5 gmEq/L was 1.82 (1.11, 2.99), correspondingly, compared to the reference group (AG < 12.5 gmEq/L). This correlation was still remarkable after adjustment for r age, sex, race, SBP, DBP, WBC, heart failure, and serum chloride (HR = 1.70, 95% CI: 1.02–2.02; 2.82). For 90-day all-cause mortality, a similar correlation was observed. Conclusions. We noted that AG was an independent indicator of both short and long-term mortalities among hip fractures individuals in this retrospective single-center cohort study. AG is a simple, readily available, and inexpensive laboratory variable that can serve as a possible risk stratification tool for hip fracture.

Association between albumin-corrected anion gap and in-hospital mortality of intensive care patients with trauma: A retrospective study based on MIMIC-Ⅲ and Ⅳ databases

“…Leskovan et al, through a retrospective study, demonstrated that an AG level exceeding 16mmol/L was significantly associated with unfavorable clinical outcomes in elderly trauma patients [ 23 ]. Zhang et al showed that patients with critical hip fracture and AG>12.5mmol/L had a 1.7-fold higher 30-day mortality rate compared to those with AG≤12.5mmol/L [ 24 ]. Trauma-related morbidity and mortality are frequently associated with hemorrhage, shock, tissue hypoperfusion resulting in metabolic acidosis and microcirculatory dysfunction, which could further lead to complications such as acute kidney injury (AKI), acute traumatic coagulopathy (ATC), adult respiratory distress syndrome (ARDS), ultimately culminating in fatality [ 21 ].…”

Association Between Serum Anion Gap and Mortality in Critically Ill Patients with COPD in ICU: Data from the MIMIC IV Database

“… 17 Recent retrospective studies have shown that elevated AG is associated with increased mortality in ICU patients with aortic aneurysm, 7 AKI requiring CRRT, 9 cardiogenic shock, 10 acute pancreatitis 11 and hip fractures. 12 Moreover, other studies have examined the correlation between AG and mortality in ICU patients. Wang et al 18 found that high AG (>14mmol/L) within 48 hours after tissue plasminogen activator (rtPA) treatment in patients with cerebral infarction was linked to significantly higher overall, 1-year, and 4-year mortality.…”

“… 6 Recent studies have shown that a high AG level is associated with increased mortality in ICU patients with conditions such as aortic aneurysm, 7 sepsis, 8 acute kidney injury(AKI) requiring continuous renal replacement therapy(CRRT), 9 cardiogenic shock, 10 acute pancreatitis 11 and hip fractures. 12 …”

CENPE and LDHA were potential prognostic biomarkers of chromophobe renal cell carcinoma

“…Features of the tumor microenvironment heavily affect disease biology and may affect responses to systemic therapy [ 52 – 55 ]. Previous studies demonstrated that LDHA was involved in the development of cancer through multiple signal pathways, including AKT/ mammalian target of rapamycin (mTOR), the c-Jun NH (2)-terminal kinase (JNK) and RIG-I like receptor signal pathway [ 56 – 58 ]. Besides, we found LDHA also promoted cancer progression through being involved in the cell cycle and DNA replication.…”