Association Between Albumin-Corrected Anion Gap and In-Hospital Mortality and Sepsis-Associated Acute Kidney Injury

BACKGROUND:This study aimed to investigate the association between albumin-corrected anion gap (ACAG) and in-hospital mortality in sepsis-associated acute kidney injury (S-AKI). MATERIAL AND METHODS:We conducted this retrospective study based on data from the Medical Information Mart for Intensive Care IV database, and assessed the prognostic capabilities of ACAG in comparison with albumin (ALB) and anion gap (AG) to predict in-hospital mortality of patients with S-AKI. Binomial logistic regression analysis was performed to identify whether ACAG was an independent risk factor for in-hospital mortality for the patients, and receiver operating characteristic (ROC) curves were plotted to clarify its efficacy in predicting in-hospital mortality. We also performed a decision curve analysis (DCA) to determine whether there were net clinical benefits for patients when ACAG was used to predict in-hospital mortality. RESULTS:Binary logistic regression analysis showed that ACAG was an independent risk factor for in-hospital mortality in patients with S-AKI, with an area under the ROC (AUC) curve of 0.675 (moderate predictive value) for the prediction of in-hospital mortality, higher than that of ALB or AG alone, with the highest Youden’s index (0.2675). The DCA substantiated the superiority of ACAG in net clinical benefits at various threshold probability, enhancing its clinical applicability. CONCLUSIONS:The research emphasizes the potential of ACAG as a valuable predictive tool for in-hospital mortality in S-AKI patients, which is better than albumin and AG, encouraging its consideration in clinical practice.