Red cell distribution width/albumin ratio and 90-day mortality after burn surgery

Abstract

Background Red cell distribution width (RDW) and serum albumin concentration are associated with postoperative outcomes. However, the usefulness of the RDW/albumin ratio in burn surgery remains unclear. Therefore, we evaluated the association between RDW/albumin ratio and 90-day mortality after burn surgery. Methods Between 2013 and 2020, a retrospective review of patients in a burn intensive care unit (ICU) was performed. Receiver operating characteristic curve, multivariate Cox logistic regression, multivariate logistic regression and Kaplan–Meier analyses were conducted to evaluate the association between RDW/albumin ratio and 90-day mortality after burn surgery. Additionally, prolonged ICU stay rate (>60 days) and ICU stay were assessed. Results Ninety-day mortality was 22.5% (210/934) in burn patients. Risk factors for 90-day mortality were RDW/albumin ratio at postoperative day 1, age, American Society of Anesthesiologists physical status, diabetes mellitus, inhalation injury, total body surface area burned, hypotensive event and red blood cell transfusion volume. The area under the curve of the RDW/albumin ratio at postoperative day 1 to predict 90-day mortality, after adjusting for age and total body surface area burned, was 0.875 (cut-off value, 6.8). The 90-day mortality was significantly higher in patients with RDW/albumin ratio >6.8 than in those with RDW/albumin ratio ≤6.8 (49.2% vs 12.3%, p < 0.001). Prolonged ICU stay rate and ICU stay were significantly higher and longer in patients with RDW/albumin ratio >6.8 than in those with RDW/albumin ratio ≤6.8 (34.5% vs 26.5%; 21 [11–38] vs 18 [7–32] days). Conclusion RDW/albumin ratio >6.8 on postoperative day 1 was associated with higher 90-day mortality, higher prolonged ICU stay rate and longer ICU stay after burn surgery.

Impact of red cell distribution width and red cell distribution width/albumin ratio on all-cause mortality in patients with type 2 diabetes and foot ulcers: a retrospective cohort study

“…In this study, the discriminating ability of RDW/ALB for all-cause mortality was significantly superior to RDW in younger, healthier, and less severely ill patients by comparative analysis of ROC curves. The ROC curves analysis also indicated that RDW/ALB ratio had better predictive power for mortality than RDW in patients undergoing burn surgery and with acute respiratory distress syndrome [ 12 , 43 ]. ALB was widely applied to assess the nutritional status and reflect the systemic inflammation [ 44 ].…”

“…However, this observation failed to be corroborated in another population [ 10 ], which may be due to the population heterogeneity. RDW/albumin (ALB) ratio is a new combined parameter that can predict mortality in patients undergoing burn surgery, and patients with diabetic ketoacidosis [ 11 , 12 ]. Diabetes-related complications were associated with an increased inflammatory burden [ 13 , 14 ].…”

Prognostic Significance of the Red Cell Distribution Width/Albumin Ratio in the Prediction of the Severity of Acute Biliary Pancreatitis: A Preliminary Report

“…Recently, many studies have been conducted with the idea that RAR may provide better results in determining the prognosis of diseases compared to the individual evaluation of either parameter in this ratio [13][14][15]. We conducted the current study for the same purpose, and to our knowledge, our study is the first to determine the predictive ability of RAR in the prognosis of ABP.…”

Red blood cell distribution width‐to‐albumin ratio is associated with all‐cause mortality in cancer patients

“… 21 , 22 The RDW‐to‐albumin (RA) ratio is a novel inflammatory biomarker, 23 which has previously been used to assess the prognosis of patients with stroke 22 and aortic aneurysms. 23 , 24 We hypothesized that the use of RDW in combination with albumin may be a potential predictor of cancer mortality. In the present study, we assessed the prognostic value RA ratio in predicting cancer mortality.…”

“…Albumin not only exerts anti‐inflammatory effects but also reduces oxidative stress and inhibits apoptosis of endothelial cells 21,22 . The RDW‐to‐albumin (RA) ratio is a novel inflammatory biomarker, 23 which has previously been used to assess the prognosis of patients with stroke 22 and aortic aneurysms 23,24 . We hypothesized that the use of RDW in combination with albumin may be a potential predictor of cancer mortality.…”