Serum anion gap on admission predicts intensive care unit mortality in patients with aortic aneurysm

It has been widely reported that the serum anion gap is significantly associated with mortality in intensive care unit (ICU); however, it remains unknown whether the association is present in aortic aneurysm (AA) patients. The present study aimed to investigate the association between the admission serum anion gap and ICU mortality in AA patients. Data extracted from a publicly accessible clinical database using a modifiable data mining technique were analyzed retrospectively, mainly by employing multivariable logistic regression analysis. The primary study outcome was ICU mortality. A total of 273 patient records were analyzed. The ICU mortality was 8.79% (24/273). The median serum anion gap was significantly higher in non-survivors [17.50 mEq/l, interquartile range (IQR) 15.75-22.50 mEq/l] compared with survivors [13.00 mEq/l, IQR 11.00-15.00 mEq/l, P<0.001]. Multivariate analysis resulted in identification of a clear association between admission serum anion gap and ICU mortality in AA patients [odds ratio (OR) 1.38 per 1 mEq/l increase, 95% confidence interval (CI) 1.08-1.76]. The area under the receiver operating characteristic curve showed an outstanding discrimination ability in predicting ICU mortality (area under curve 0.8513, 95% CI 0.7698-0.9328). In conclusion, admission serum anion gap may serve as a strong predictor of ICU mortality for AA patients.