---
title: "Albumin-Corrected Anion Gap Predicts In-Hospital Mortality in Traumatic Lung Injury: Multicenter R"
id: "pubmed-42626900"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42626900"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42626900/"
doi: "10.1177/10815589261483651"
published_at: "2026-08-21T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Albumin-Corrected Anion Gap Predicts In-Hospital Mortality in Traumatic Lung Injury: Multicenter R
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42626900
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42626900/)
- **DOI:** [10.1177/10815589261483651](https://doi.org/10.1177%2F10815589261483651)
- **Published At:** 2026-08-21T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This multicenter retrospective cohort study evaluated the association between the **albumin-corrected anion gap (ACAG)** and in-hospital mortality in patients with **traumatic lung injury (TLI)** using two large ICU databases. - Data were drawn from the MIMIC-IV-3.1 database (training set, n=239) and the eICU Collaborative Research Database (external validation, n=467). - The study tested the relationship between **ACAG** and mortality with restricted cubic spline models, Cox proportional hazards models, and Kaplan–Meier curves; it found a linear relationship. - Higher **ACAG** was significantly associated with increased risk of in-hospital death (reported hazard ratio [HR] = 1.115 with 95% confidence interval 1.037–1.199). - The Boruta algorithm identified **ACAG** as a feature with high importance for outcome prediction among candidate variables. - Machine learning–based prediction models incorporating **ACAG** were developed on MIMIC-IV data and externally validated on eICU-CRD data; models including ACAG showed superior predictive performance by ROC analysis and decision curve analysis. - Authors conclude that **ACAG** may serve as a potential predictor of adverse outcomes in patients with **TLI** in the ICU. - The study used established public critical care datasets and standard statistical and ML techniques; specific model types, hyperparameters, and other variable details were not reported in the abstract.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # EXPRESS: Relation between Albumin-Corrected Anion Gap and In-Hospital Mortality in Patients with Traumatic Lung Injury: A Multicenter Retrospective Cohort Study and the Development of Machine Learning-Based Prediction Models [Hong Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+H&cauthor_id=42626900)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42626900/#full-view-affiliation-1 "Department of Critical Care Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunnan 653100, China."), [Fanghao Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+F&cauthor_id=42626900)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42626900/#full-view-affiliation-2 "Department of Thoracic Surgery II, The First Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650000, China."), [Dong Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+D&cauthor_id=42626900)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42626900/#full-view-affiliation-1 "Department of Critical Care Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunnan 653100, China."), [Wei Yi](https://pubmed.ncbi.nlm.nih.gov/?term=Yi+W&cauthor_id=42626900)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42626900/#full-view-affiliation-1 "Department of Critical Care Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunnan 653100, China."), [Zixin Qi](https://pubmed.ncbi.nlm.nih.gov/?term=Qi+Z&cauthor_id=42626900)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42626900/#full-view-affiliation-3 "Department of Respiratory and Critical Care Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunnan, 653100, China.") Affiliations Expand ### Affiliations * 1 Department of Critical Care Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunnan 653100, China. * 2 Department of Thoracic Surgery II, The First Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650000, China. * 3 Department of Respiratory and Critical Care Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunnan, 653100, China. * PMID: **42626900** * DOI: [ 10.1177/10815589261483651 ](https://doi.org/10.1177/10815589261483651) Item in Clipboard # EXPRESS: Relation between Albumin-Corrected Anion Gap and In-Hospital Mortality in Patients with Traumatic Lung Injury: A Multicenter Retrospective Cohort Study and the Development of Machine Learning-Based Prediction Models Hong Wang et al. J Investig Med. 2026. Show details Display options Display options Format Abstract PubMed PMID J Investig Med Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Investig+Med%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Investig+Med%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42626900/) . 2026 Aug 21:10815589261483651. doi: 10.1177/10815589261483651. Online ahead of print. ### Authors [Hong Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+H&cauthor_id=42626900)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42626900/#short-view-affiliation-1 "Department of Critical Care Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunnan 653100, China."), [Fanghao Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+F&cauthor_id=42626900)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42626900/#short-view-affiliation-2 "Department of Thoracic Surgery II, The First Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650000, China."), [Dong Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+D&cauthor_id=42626900)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42626900/#short-view-affiliation-1 "Department of Critical Care Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunnan 653100, China."), [Wei Yi](https://pubmed.ncbi.nlm.nih.gov/?term=Yi+W&cauthor_id=42626900)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42626900/#short-view-affiliation-1 "Department of Critical Care Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunnan 653100, China."), [Zixin Qi](https://pubmed.ncbi.nlm.nih.gov/?term=Qi+Z&cauthor_id=42626900)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42626900/#short-view-affiliation-3 "Department of Respiratory and Critical Care Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunnan, 653100, China.") ### Affiliations * 1 Department of Critical Care Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunnan 653100, China. * 2 Department of Thoracic Surgery II, The First Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650000, China. * 3 Department of Respiratory and Critical Care Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunnan, 653100, China. * PMID: **42626900** * DOI: [ 10.1177/10815589261483651 ](https://doi.org/10.1177/10815589261483651) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** The anion gap is primarily utilized as an indicator for evaluating acid-base imbalances in critically ill patients. However, its accuracy is reduced in such patients due to low albumin levels. The albumin-corrected anion gap (ACAG) enhances the accuracy of assessing acid-base imbalances. Individuals with traumatic lung injury (TLI) in the intensive care unit (ICU) often have severe metabolic acidosis and hypoalbuminemia. Nevertheless, the association of ACAG with the prognosis of patients with TLI is still unknown. **Methods:** Clinical data of individuals with TLI were acquired from the Medical Information Mart for Intensive Care (MIMIC)-IV-3.1 database and the eICU Collaborative Research Database (eICU-CRD), created by Philips Healthcare and the Massachusetts Institute of Technology. Data from the MIMIC-IV database were utilized as the training set to develop machine learning-based models. In contrast, data from the eICU-CRD were adopted for external validation of the established models. The primary outcome was in-hospital mortality. The association of ACAG with in-hospital mortality was evaluated using restricted cubic spline (RCS) models, Cox proportional hazards models, and Kaplan-Meier curves. The Boruta algorithm was adopted for the selection of feature variables. The predictive power of ACAG was evaluated, and prediction models were established utilizing machine learning algorithms. Model performance was verified with receiver operating characteristic (ROC) curves and decision curve analysis. **Results:** A total of 239 and 467 individuals were incorporated from the MIMIC-IV database and the eICU-CRD, respectively. RCS curve analysis revealed a linear association of ACAG with in-hospital mortality. Elevated ACAG was substantially linked to a high risk of mortality in individuals with TLI (hazard ratio (HR) [95% confidence interval (CI)] = 1.115 [1.037-1.199]). The Boruta algorithm demonstrated that ACAG possessed higher feature importance. Prediction models established based on ACAG exhibited the optimal predictive performance. **Conclusion:** ACAG exhibited a linear association with in-hospital mortality among individuals with TLI, and a high ACAG was related to a markedly elevated risk of in-hospital death. Therefore, ACAG may serve as a potential predictor of adverse outcomes in individuals with TLI. **Keywords:** Intensive Care Units. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ The association between albumin-corrected anion gap and in-hospital mortality in critically ill COPD patients: A multicenter retrospective study from eICU collaborative research database. ](https://pubmed.ncbi.nlm.nih.gov/40961782/) Long Z, Xian G, Xiang Z, Zhu X, Zhou Y, Li Z, Li S, Zhan Y, Ye F, Wang Y.Long Z, et al.J Crit Care. 2026 Feb;91:155260. doi: 10.1016/j.jcrc.2025.155260. Epub 2025 Sep 16.J Crit Care. 2026.PMID: 40961782 * [ Association between albumin-corrected anion gap and in-hospital mortality in ICU patients with lung cancer: a retrospective cohort study based on the MIMIC database. ](https://pubmed.ncbi.nlm.nih.gov/41988317/) Wang Y, Yang L, Zhu M, Shi X, Xiong R, Nie H.Wang Y, et al.J Thorac Dis. 2026 Mar 31;18(3):214. doi: 10.21037/jtd-2025-aw-2340. 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