Albumin corrected anion gap for predicting in-hospital mortality among intensive care patients with sepsis: A retrospective propensity score matching analysis

• Albumin corrected anion gap was related to in-hospital mortality in intensive care patients with sepsis. • Albumin corrected anion gap has a better predictive value. • Albumin corrected anion gap may obtain the highest net benefit. The relationship between albumin corrected anion gap (ACAG) and in-hospital mortality of intensive care sepsis patients is currently inconclusive. The baseline data, concentration of albumin, anion gap (AG), ACAG and in-hospital prognosis of intensive care patients with sepsis were retrieved from the Medical Information Mart for Intensive Care IV database. Propensity score matching (PSM) analysis was performed to reduce bias. Receiver operating characteristic curves were drawn for albumin, AG, and ACAG, and comparisons between the areas under the ROC curves were conducted. Decision curve analysis (DCA) was performed to determine the net benefit of ACAG. ACAG was related to in-hospital mortality in intensive care patients with sepsis. The AUCs of ACAG were 0.689 (before PSM) and 0.644 (after PSM), which were significantly higher than that of albumin or AG. The Youden’s index of ACAG was the highest, and the net benefit range of ACAG was also the largest according to the DCA. ACAG has the highest predictive value for in-hospital mortality of intensive care patients with sepsis, which is better than albumin and AG. Using ACAG to predict the in-hospital mortality to guide clinical applications may obtain the highest net benefit.