Low Hemoglobin-to-Red Cell Distribution Width Ratio Is Associated with Disease Progression and Poor Prognosis in Upper Tract Urothelial Carcinoma

Su, Yung Chun; Sheng, Wen; Li, Ching Chia; Su, Hsiao Chun; Ke, Hung‐Lung; Li, Wei Ming; Lee, Hsiang-Ying; Yang, Sheau-Fang; Tu, Hung-Pin; Wu, Wen Jeng; Yeh, Hsin Chih

doi:10.3390/biomedicines9060672

Cited by 14 publications

(6 citation statements)

References 60 publications

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“…HGB/RDW as a new comprehensive biomarker has gradually attracted widespread attention. The lower HGB/RDW levels have been demonstrated to be associated with cancer development and poor prognosis (37,38). In the present case, HIV patients with lower levels of HGB/RDW had a higher risk of cytopenia during hospitalization.…”

Section: Discussionsupporting

confidence: 46%

Prediction of the risk of cytopenia in hospitalized HIV/AIDS patients using machine learning methods based on electronic medical records

Huang¹,

Xie

Zhang³

et al. 2023

Front. Public Health

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BackgroundCytopenia is a frequent complication among HIV-infected patients who require hospitalization. It can have a negative impact on the treatment outcomes for these patients. However, by leveraging machine learning techniques and electronic medical records, a predictive model can be developed to evaluate the risk of cytopenia during hospitalization in HIV patients. Such a model is crucial for designing a more individualized and evidence-based treatment strategy for HIV patients.MethodThe present study was conducted on HIV patients who were admitted to Guangxi Chest Hospital between June 2016 and October 2021. We extracted a total of 66 clinical features from the electronic medical records and employed them to train five machine learning prediction models (artificial neural network [ANN], adaptive boosting [AdaBoost], k-nearest neighbour [KNN] and support vector machine [SVM], decision tree [DT]). The models were tested using 20% of the data. The performance of the models was evaluated using indicators such as the area under the receiver operating characteristic curve (AUC). The best predictive models were interpreted using the shapley additive explanation (SHAP).ResultThe ANN models have better predictive power. According to the SHAP interpretation of the ANN model, hypoproteinemia and cancer were the most important predictive features of cytopenia in HIV hospitalized patients. Meanwhile, the lower hemoglobin-to-RDW ratio (HGB/RDW), low-density lipoprotein cholesterol (LDL-C) levels, CD4+ T cell counts, and creatinine clearance (Ccr) levels increase the risk of cytopenia in HIV hospitalized patients.ConclusionThe present study constructed a risk prediction model for cytopenia in HIV patients during hospitalization with machine learning and electronic medical record information. The prediction model is important for the rational management of HIV hospitalized patients and the personalized treatment plan setting.

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Section: Discussionsupporting

confidence: 46%

Prediction of the risk of cytopenia in hospitalized HIV/AIDS patients using machine learning methods based on electronic medical records

Huang¹,

Xie

Zhang³

et al. 2023

Front. Public Health

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“…Third, low level of HRR could be an independent risk factor for sarcopenia. Forth, the cutoff value of HRR for sarcopenia were 0.84 HRR is a novel marker of in ammation, and lower HRR level has been proved to be related with many adverse consequences such as fratily (19), disease progression and poor prognosis (20)(21)(22) and lower disease-free survival time (23,24). Our study shows that low level of HRR may be an independent risk factor for sarcopenia and it may be related with Hb.…”

Section: Discussionmentioning

confidence: 57%

Association of Hemoglobin-to-red blood cell distribution width ratio and risk of sarcopenia: a cross sectional study

Zhou

et al. 2023

Preprint

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Background The incidence rate of sarcopenia is high and it will lead to many adverse consequences. It is necessary to explore the influencing factors of sarcopenia and find out its inflammatory indicators. Objectives We aimed to explore the association between hemoglobin-to-red blood cell distribution width ratio (HRR) and the risk of sarcopenia from the large and diverse National Health and Nutrition Examination Survey (NHANES) 1999–2006, 2011–2018 population sample. Methods The general characteristics, disease related characteristics, diet and exercise characteristics, blood indicators, appendicular lean mass index, the peak isokinetic strength of the knee extensors, gait speed, combined grip strength and appendicular lean mass index extracted from the adult(18-79y) from the NHANES database. t test, two sample Kolmogorove-Smirnov test, Chi-square test, multiple linear regression analyses, binary logistic regression was used to assess the association between HRR and sarcopenia. The cut-off value invented by Budczies et al was used to found the cut-off value for the HRR to sarcopenia. Results A total sample of 28,531 participants were included in the study (50.85% males and 49.15% females). The prevance of sarcopenia is 23.87% (43.52% males and 56.48% females) and severe-sarcopenia is 18.13% (53.03% males and 46.97% females). HRR levels were significantly lower in sarcopenic people than non-sarcopenic people, and lower in severe-sarcopenia people than light-sarcopenia people(P < 0.05). HRR was significantly positive associated with appendicular lean mass index (ALMI), gait speed, peak isokinetic, and combined grip strength (P < 0.05). Regression analysis shows that HRR was independently associated with sarcopenia (P < 0.05). Conclusions This study first reveal that HRR is an independent risk factor for sarcopenia and the mechanism of HRR to sarcopenia is not clear. It is necessary to further explore the mechanism of HRR to sarcopenia in the future research.

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“…The relationship between HRR and in-hospital mortality remains unknown, which prompted us to carry out the current study. A series of previous studies have demonstrated that a low level of HRR was associated with poor outcomes among multiple malignant diseases (25,33,(38)(39)(40)(41). In recent years, there was mounting evidence that a lower level of HRR was strongly associated with significantly worse outcomes in many critically ill patients, such as coronary heart disease (28), sepsis (29), ischemic stroke (30), and so on.…”

Section: Discussionmentioning

confidence: 99%

Association between hemoglobin-to-red blood cell distribution width ratio and hospital mortality in patients with non-traumatic subarachnoid hemorrhage

Liu

Wang

2023

Front. Neurol.

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BackgroundIn patients with ischemic stroke, low hemoglobin-to-red blood cell distribution width ratio (HRR) was associated with an increased risk of mortality. However, it was unknown in the non-traumatic subarachnoid hemorrhage (SAH) population. The purpose of this study was to examine the association between baseline HRR and in-hospital mortality in patients with non-traumatic SAH.MethodsNon-traumatic SAH patients were screened out of the Medical Information Mart for Intensive IV (MIMIC-IV) database between 2008 and 2019. The Cox proportional hazard regression models were utilized to analyze the association between baseline HRR and in-hospital mortality. Restricted cubic splines (RCS) analysis was utilized to determine the relationship curve between hospital mortality and the HRR level and examine the threshold saturation effect. We further applied Kaplan–Meier survival curve analysis to examine the consistency of these correlations. The interaction test was used to identify subgroups with differences.ResultsA total of 842 patients were included in this retrospective cohort study. Compared with individuals with lower HRR Q1 ( ≤ 7.85), the adjusted HR values in Q2 (7.86–9.15), Q3 (9.16–10.16), and Q4 (≥10.17) were 0.574 (95% CI: 0.368–0.896, p = 0.015), 0.555 (95% CI: 0.346–0.890, p = 0.016), and 0.625 (95% CI: 0.394–0.991, p = 0.045), respectively. The association between the HRR level and in-hospital mortality exhibited a non-linear relationship (p < 0.05). The threshold inflection point value of 9.50 was calculated using RCS analysis. When the HHR level was lower than 9.50, the risk of in-hospital mortality rate decreased with an adjusted HR of 0.79 (95% CI: 0.70–0.90, p = 0.0003). When the HRR level was higher than 9.50, the risk of in-hospital mortality almost hardly increased with the increase in the HRR level (adjusted HR = 1.18, 95% CI: 0.91–1.53, p = 0.2158). K-M analysis showed that patients with low HRR levels had significantly higher in-hospital mortality (p < 0.001).ConclusionThere was a non-linear connection between the baseline HRR level and in-hospital mortality. A low level of HRR could increase the risk of death in participants with non-traumatic SAH.

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Low Hemoglobin-to-Red Cell Distribution Width Ratio Is Associated with Disease Progression and Poor Prognosis in Upper Tract Urothelial Carcinoma

Cited by 14 publications

References 60 publications

Prediction of the risk of cytopenia in hospitalized HIV/AIDS patients using machine learning methods based on electronic medical records

Prediction of the risk of cytopenia in hospitalized HIV/AIDS patients using machine learning methods based on electronic medical records

Association of Hemoglobin-to-red blood cell distribution width ratio and risk of sarcopenia: a cross sectional study

Association between hemoglobin-to-red blood cell distribution width ratio and hospital mortality in patients with non-traumatic subarachnoid hemorrhage

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