J Korean Soc Emerg Med.  2005 Feb;16(1):45-50.

Prognostic Value of an Initial Strong Ion Gap in Critically Ill Patients at the Emergency Department

Affiliations
  • 1Department of Emergency Medicine, Pundang Jesaeng Hospital, Seongnam, Korea. rocky66@dmc.or.kr

Abstract

PURPOSE
This study was performed to determine whether the anion gap, the base excess, the lactate, and the strong ion gap obtained in the emergency department correlate with the prognosis and whether the strong ion gap is the most useful marker compared to the prognostic ability of the anion gap, the base excess, and the lactate.
METHODS
We reviewed the records of 106 patients admitted to the intensive care unit via the emergency department. We measured the anion gap, the base excess, and the lactate and we calculated strong anion gap by using a formula. We divided the patients into survivors and nonsurvivors and compared the prognostic abilities of the four variables by using the Student's t-test and receiver operator characteristic curves.
RESULTS
The mean age of the patients was 67+/-14, and the numbers of males and females were similar (58 males vs 48 females). The number of survivors was 92 (86.7%), and that of nonsurvivors was 14 (3.2%). The anion gap ( 24.8+/-8.8 vs. 16.4+/-4.8 mmol/L, p value=0.000), the base excess (-11.9+/-8.7 vs. -3.49+/-6.5 mmol/L, p value = 0.001), the lactate (9.1+/-7.7 vs. 4.5+/-3.1 mmol/L, p value = 0.011 ) and the strong ion gap (16.6+/-3.6 vs. 10.9+/-3.7, p value=0.000) of the nonsurvivors were higher. All of the four varibles were associated with the prognosis, but among them, the strong ion gap discriminated most strongly with an area under the receiver operator characteristic curve of 0.866 (95% confidence interval, 0.787 to 0.92).
CONCLUSION
The initial emergency-department acid-base variables, the anion gap, the base excess, the lactate and the strong ion gap have prognostic abilities, but the strong ion gap is the variable that most strongly predicts of mortality.

Keyword

Anion gap; Lactic acid; Prognosis; Mortality

MeSH Terms

Acid-Base Equilibrium
Critical Illness*
Emergencies*
Emergency Service, Hospital*
Female
Humans
Intensive Care Units
Lactic Acid
Male
Mortality
Prognosis
Survivors
Lactic Acid
Full Text Links
  • JKSEM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr