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A comparison of prognostic significance of strong ion gap (SIG) with other acid-base markers in the critically ill: a cohort study

Overview of attention for article published in Journal of Intensive Care, June 2016
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (86th percentile)

Mentioned by

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1 news outlet
twitter
6 tweeters

Citations

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26 Dimensions

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32 Mendeley
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Title
A comparison of prognostic significance of strong ion gap (SIG) with other acid-base markers in the critically ill: a cohort study
Published in
Journal of Intensive Care, June 2016
DOI 10.1186/s40560-016-0166-z
Pubmed ID
Authors

Kwok M. Ho, Norris S. H. Lan, Teresa A. Williams, Yusra Harahsheh, Andrew R. Chapman, Geoffrey J. Dobb, Sheldon Magder

Abstract

This cohort study compared the prognostic significance of strong ion gap (SIG) with other acid-base markers in the critically ill. The relationships between SIG, lactate, anion gap (AG), anion gap albumin-corrected (AG-corrected), base excess or strong ion difference-effective (SIDe), all obtained within the first hour of intensive care unit (ICU) admission, and the hospital mortality of 6878 patients were analysed. The prognostic significance of each acid-base marker, both alone and in combination with the Admission Mortality Prediction Model (MPM0 III) predicted mortality, were assessed by the area under the receiver operating characteristic curve (AUROC). Of the 6878 patients included in the study, 924 patients (13.4 %) died after ICU admission. Except for plasma chloride concentrations, all acid-base markers were significantly different between the survivors and non-survivors. SIG (with lactate: AUROC 0.631, confidence interval [CI] 0.611-0.652; without lactate: AUROC 0.521, 95 % CI 0.500-0.542) only had a modest ability to predict hospital mortality, and this was no better than using lactate concentration alone (AUROC 0.701, 95 % 0.682-0.721). Adding AG-corrected or SIG to a combination of lactate and MPM0 III predicted risks also did not substantially improve the latter's ability to differentiate between survivors and non-survivors. Arterial lactate concentrations explained about 11 % of the variability in the observed mortality, and it was more important than SIG (0.6 %) and SIDe (0.9 %) in predicting hospital mortality after adjusting for MPM0 III predicted risks. Lactate remained as the strongest predictor for mortality in a sensitivity multivariate analysis, allowing for non-linearity of all acid-base markers. The prognostic significance of SIG was modest and inferior to arterial lactate concentration for the critically ill. Lactate concentration should always be considered regardless whether physiological, base excess or physical-chemical approach is used to interpret acid-base disturbances in critically ill patients.

Twitter Demographics

The data shown below were collected from the profiles of 6 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 32 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Japan 1 3%
Unknown 31 97%

Demographic breakdown

Readers by professional status Count As %
Lecturer 4 13%
Researcher 4 13%
Other 3 9%
Student > Ph. D. Student 3 9%
Student > Master 3 9%
Other 9 28%
Unknown 6 19%
Readers by discipline Count As %
Medicine and Dentistry 19 59%
Nursing and Health Professions 2 6%
Pharmacology, Toxicology and Pharmaceutical Science 1 3%
Decision Sciences 1 3%
Engineering 1 3%
Other 0 0%
Unknown 8 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 12. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 January 2020.
All research outputs
#1,984,780
of 18,880,385 outputs
Outputs from Journal of Intensive Care
#103
of 439 outputs
Outputs of similar age
#36,487
of 270,296 outputs
Outputs of similar age from Journal of Intensive Care
#1
of 1 outputs
Altmetric has tracked 18,880,385 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 439 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.5. This one has done well, scoring higher than 76% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 270,296 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 86% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them