The Value Of Strong Ion Gap In The Evaluation Of The Condition And Prognosis Of Patients With AECOPD

Objective:Retrospective analysis of the strong ion gap(SIG,strong ion gap)and blood gas related parameters measured during the admission of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in our hospital To evaluate the predictive value of these indicators for the development and death of AECOPD patients.Methods:Collected the AECOPD patients admitted to the Department of Emergency Medicine,Respiratory Medicine and Critical Care Medicine of the First Affiliated Hospital of Wannan Medical College from September 2017 to July 2019.Blood gas analysis was performed within 24 hours after admission.Perform relevant scoring and divide all cases into three groups according to their condition.By calculating SIG and related indicators involved in the calculation process,SPSS 25.0 was used to analyze the obtained data.Single factor and multiple regression analysis were used to evaluate the accuracy of these indicators in predicting the severity and mortality of AECOPD patients.Results:A total of 142 effective clinical data were collected in this study.Including 45 cases in grade I group,63 cases in grade Ⅱ group,34 cases in grade Ⅲ group.Among them,49 cases were complicated with chronic respiratory failure,35 cases were complicated with pulmonary heart disease,13 cases were complicated with two diseases at the same time,7 patients died,accounting for 4.93%.The median of SIG in group Ⅲ was significantly higher than that in group Ⅱ and group Ⅰ,the difference was statistically significant(P<0.001).Multiple ordered logistic regression analysis showed that the increase of SIG,eosinophils,and PCT indexes were independent risk factors for the severity of AECOPD patients.ROC curve analysis of the predictive value of eosinophils,SIG,and PCT for the severity of the patient’s condition showed that the area under the curve was 0.950(0.915-0.985),0.907(0.858-0.955),0.769(0.690-0.848).The areas under the ROC curve of the predictive value of acid granulocytes,SIG,and PCT for the prognosis of patients were 0.711(0.503 to 0.918),0.822(0.698 to 0.945),and 0.784(0.614 to 0.955).Conclusion:1.SIG has significant differences in AECOPD patients with different severity and different prognosis;2.SIG is a reliable reference index for evaluating the severity of AECOPD patients,but its value is not as good as eosinophils;3.SIG can be used as an accurate predictor of mortality in AECOPD patients.