Background. Congestive heart failure (CHF) is a complex clinical syndrome, with high morbidity and mortality. Serum anion gap (SAG) is associated with the severity of various cardiovascular diseases. However, the role of SAG indicators in CHF is unclear. Methods and Results. A retrospective analysis of data from Multiparameter Intelligent Monitoring in Intensive Care III version 1.4 was conducted in critically ill patients with CHF. The clinical information of each patient, including demographic data, comorbidities, vital signs, scores, and laboratory indicators, were successfully obtained. Cox proportional hazards models were used to determine the relationship between SAG and mortality in patients with CHF, the consistency of which was further verified by subgroup analysis. Results. A total of 7426 subjects met the inclusion criteria. Multivariate analysis showed that after adjusting for age, gender, ethnicity, and other potential confounders, increased SAG was significantly related to an increase in 30- and 90-day all-cause mortalities of critically ill patients with CHF compared with decreased SAG (tertile 3 versus tertile 1: adjusted hazard ratio, 95% confidence interval: 1.74, 1.46–2.08; 1.53, 1.32–1.77). Subgroup analysis indicated that the association between SAG and all-cause mortality presented similarities in most strata. Conclusion. SAG at admission could be a promising predictor of all-cause mortality in critically ill patients with CHF.

中文翻译：

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血清阴离子间隙与充血性心力衰竭重症患者的全因死亡率相关

背景。充血性心力衰竭（CHF）是一种复杂的临床综合征，发病率和死亡率都很高。血清阴离子间隙（SAG）与各种心血管疾病的严重程度有关。然而，SAG 指标在 CHF 中的作用尚不清楚。方法和结果。对重症监护病房多参数智能监测 III 1.4 版的数据进行了回顾性分析，研究对象为患有 CHF 的危重患者。成功获取了每位患者的临床信息，包括人口统计学数据、合并症、生命体征、评分和实验室指标。采用 Cox 比例风险模型确定 CHF 患者 SAG 与死亡率的关系，亚组分析进一步验证了其一致性。结果. 共有 7426 名受试者符合纳入标准。多变量分析表明，在调整年龄、性别、种族和其他潜在混杂因素后，与 SAG 降低相比，SAG 增加与 CHF 危重患者 30 天和 90 天全因死亡率增加显着相关（三分位数 3与三分位数 1：调整后的风险比，95% 置信区间：1.74, 1.46–2.08; 1.53, 1.32–1.77)。亚组分析表明，SAG 与全因死亡率之间的关联在大多数阶层中呈现出相似性。结论。入院时的 SAG 可能是 CHF 重症患者全因死亡率的有希望的预测指标。