Corrected Anion Gap and Hypernatremia as Predictors of Mortality in Pediatric Intensive Care Unit, Minia University Hospital: A Retrospective Study

F. Afify, Mohamed; Hamdy, Yomna; Abdel Aziz, Reem

doi:10.22038/ijp.2020.50734.4031

Corrected Anion Gap and Hypernatremia as Predictors of Mortality in Pediatric Intensive Care Unit, Minia University Hospital: A Retrospective Study

Document Type : original article

Authors

Mohamed F. Afify ¹

Yomna Hamdy ²

Reem Abdel Aziz ³

¹ Professor of Pediatrics, Minia University, Egypt.

² Resident of Pediatrics, Minia University, Egypt.

³ Associate professor of Pediatrics, Minia University, Egypt.

10.22038/ijp.2020.50734.4031

Abstract

Background
Hypernatremia commonly occurs in ICUs, mostly developing soon after admission. It has been associated with prolonged ICU stay and has a mortality rate of 40–60%. The aim of our study is to estimate the values of serum anion gap (AG), corrected anion gap (CAG), and hypernatremia for an early prediction of mortality in pediatric intensive care units (PICUs).
Materials and Methods
This retrospective comparative study used data collected from the records of children admitted to the PICU at Minia University Hospital between June, 2017 and June, 2019.
Results
Patients were from 1 month to 18 years old. ROC curve analysis for the prediction of mortality showed the cutoff point of Na >154 (64.04% sensitivity and 79.75% specificity) and of cAG > 42.1 (57.37% sensitivity and 70.25% specificity).
Conclusion
Ventilation, respiratory failure, severe and moderate GCS, PH, CO2, anion gap, high cAG, hypernatremia, K, CL, CRP, PLT, and creatinine were significant predictors of mortality among children admitted to the PICU.

Keywords

Anion gap

Corrected anion gap

Hypernatremia

Pediatric Intensive Care Unit