J Korean Soc Emerg Med.  2006 Oct;17(5):454-462.

Initial Unmeasured Anions on Emergency Department in Critically ill Patients: Can they Predict the Morbidity?

• Shin TY
• Ha YR
• Kim YI
• Go CY
• An SJ
• Kim DU
• Lee SS
• Pak DH
• Cho HY

Abstract

PURPOSE: To determine whether initial corrected anion gap (C(o)AG), base excess caused by unmeasured anions (BEua), and strong ion gap (SIG) can predict the morbidity of critically ill patients admitted to emergency department (ED).
METHODS
138 patients who visited the critical section of the ED and were admitted to intensive care unit (ICU) were enrolled. We calculated the C(o)AG, BEua, and SIG from the initial blood samples of the patients and initial logistic organ dysfunction score (LODS) also. Then we measured the LODS at the last day of ICU stay again. Comparing with the initial LODS, we divided the patients into two groups based on the changes of the values: favorable group and poor group.
RESULTS
There was a significant difference in the mean AGcorr (p=0.007), BEua (p=0.008), SIG (p=0.037) between favorable and poor group. The area under the receiver operating characteristic (AUROC) curves for morbidity prediction were relatively small: 0.66 (95% CI, 0.56-0.77) for C(o)AG, 0.65 (95% CI, 0.54-0.76) for BEua, and 0.59 (95% CI, 0.49-0.70) for SIG.
CONCLUSION
We found the initial unmeasured anions at the ED of the patients who eventually showed improved LODS during ICU period are significantly different to those of the other patients. But they failed to show enough capability of discriminating the morbidities between two groups.

Keyword

Anions; Anion Gap; Morbidity; Logistics

MeSH Terms

Acid-Base Equilibrium
Anions*
Critical Illness*
Emergencies*
Emergency Service, Hospital*
Humans
Intensive Care Units
Organ Dysfunction Scores
Organization and Administration
ROC Curve
Anions