The prediction value of serum anion gap for short-term mortality in pulmonary hypertension patients with sepsis: a retrospective cohort study.

Background: The relationship between anion gap (AG) and short-term mortality of pulmonary hypertension (PH) patients with sepsis in the intensive care unit (ICU) remains unclear. Methods: This study involved a retrospective analysis of incident PH patients with sepsis first admitted to the ICU in the MIMIC IV database (2008 to 2019). Short-term outcomes include in-hospital mortality and 28-day mortality. According to the AG value (17.0 mmol/L), patients were divided into high-AG and low-AG groups. The Kaplan-Meier survival curve was used to compare the cumulative survival rates of the high and low groups using the log-rank test. Multivariable Cox regression analyses were constructed to assess the relationship between AG and short-term outcomes in PH patients with sepsis. Results: A total of 2,012 sepsis patients with PH were included. The in-hospital mortality rates (11.4%) and 28-day mortality rates (12.8%) in the high-AG group were higher than those in the low-AG group (5.0% or 7.2%, respectively; Conclusion: Elevated serum AG is associated with increased risk-adjusted short-term mortality in PH patients with sepsis, and it may aid clinicians in identifying patients with poor prognosis as early as possible.