Serum Anion Gap Predicts Lactate Poorly, but May Be Used to Identify Sepsis Patients at Risk for Death: A Cohort Study

Our study of 4,159 emergency department patients determined anion gap and serum bicarbonate poorly predict changes in lactate and mortality. In resource-limited settings where lactate is unavailable, anion gap ≥ 20 mEq/L may be used to further risk-stratify patients for ongoing sepsis care, but lactate remains a preferred biomarker.