{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:07:01Z","timestamp":1752192421397,"version":"3.41.2"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec014\">\n<jats:title>Background<\/jats:title>\n<jats:p>Serum anion gap has diagnostic value in patients with multiple myeloma, but its association with ICU mortality and threshold value remain unclear.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec015\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Multiple myeloma patients meeting criteria were selected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The exposure factor was serum anion gap, and the outcome was ICU in-hospital mortality. Multivariable-adjusted Cox regression, curve fitting, and forest plots were used to evaluate the relationship between anion gap and ICU mortality in multiple myeloma patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec016\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 323 eligible subjects were included (206 males [63.8%], 117 females [36.2%]). Multivariable Cox regression showed that each 1-unit increase in AG was associated with a 7% increased mortality risk (HR\u2009=\u20091.07, 95%CI\u2009=\u20091.01\u20131.14, P\u2009=\u20090.032). Curve fitting revealed a nonlinear relationship between anion gap and ICU mortality (nonlinear P\u2009=\u20090.038), with the lowest risk at 15.29 mmol\/L. Incorporating AG into traditional risk factor models improved mortality prediction (P\u2009=\u20090.038).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec017\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Serum anion gap exhibits a nonlinear relationship with ICU mortality in multiple myeloma patients, with the lowest risk observed at approximately 15.29 mmol\/L.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0328014","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T17:54:14Z","timestamp":1752170054000},"page":"e0328014","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Relationship between serum anion gap and mortality in ICU in multiple myeloma patients in the MIMIC database: A retrospective cohort 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