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COMPARISON OF THE ROLE OF ESTIMATED ANION GAP WITH SOFA SCORE, APACHE II SCORE, AND LACTATE LEVELS IN PREDICTING MORTALITY IN SEVERE INFECTION (SEPSIS) PATIENTS AT A9 RESCUE CENTER – BACH MAI HOSPITAL
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Abstract
Objectives: Comparison of the role of estimated anion gap with SOFA score, APACHE II score, and blood lactate concentration in predicting 30-day mortality in patients with severe sepsis at Emergency Center A9 – Bach Mai Hospital. Methods: A prospective descriptive study of 206 patients with sepsis from October 2024 to March 2025. Selection criteria included: Patients ≥ 16 years old, diagnosed with sepsis according to the Sepsis-3 2016 criteria of the Surviving Sepsis Campaign. Results: The ROC curve of estimated anion gap (AG) for predicting 30-day mortality showed AUC = 0.758 (95% CI: 0.691-0.825), with an optimal cutoff value of 17.85 mEq/L, sensitivity of 76.2%, and specificity of 68.0%. Estimated AG demonstrated superior prognostic value for 30-day mortality compared to SOFA score (AUC = 0.726), blood lactate concentration (AUC = 0.691), and APACHE II score (AUC = 0.648). In multivariate regression analysis, AG remained the strongest prognostic factor for mortality with adjusted OR = 3.57 (95% CI: 1.73-7.38; p = 0.001), higher than lactate (OR = 2.12), SOFA (OR = 2.09), and APACHE II (OR = 1.83). Conclusions: Estimated anion gap can be used as a substitute parameter to predict mortality risk in patients with severe sepsis (Sepsis) in conjunction with blood lactate levels, SOFA score, and APACHE II score when other resources are not immediately available.
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Keywords
SOFA score, APACHE II score, anion gap, mortality prognosis, sepsis, serum lactate concentration
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